{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T14:48:28Z","timestamp":1785941308303,"version":"3.56.0"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,3,12]],"date-time":"2013-03-12T00:00:00Z","timestamp":1363046400000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Birth"],"published-print":{"date-parts":[[2013,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although management of twin deliveries has been a topic of discussion for decades, a consensus on how to deliver twins is lacking. The objective of this study was to examine short\u2010term neonatal outcome of the second twin delivered by cesarean section after vaginal delivery of the first\u2010born twin (combined delivery) and to identify predictors of combined delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study was a 3\u2010year, population\u2010based, retrospective cohort investigation of 1,254 twin births in Denmark. The twin births were divided into three groups: vaginal deliveries, planned cesarean deliveries, and combined deliveries. Data were extracted from medical records, a fetal medicine software program (<jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>straia), and the National Birth Registry. Short\u2010term poor neonatal outcome was measured as a 5\u2010minute Apgar score \u2264\u00a07, umbilical cord <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content>\u00a0\u2264\u00a07.10, and admission to neonatal intensive care unit for more than 3\u00a0days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Vertex\u2010nonvertex fetal presentations were more prevalent in combined deliveries than vaginal deliveries (OR 4.4, 2.5\u20137.8). Nonvertex second twins born by combined delivery had a higher risk of Apgar score \u2264\u00a07 and umbilical cord <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content>\u00a0\u2264\u00a07.10 compared with vaginal delivery, unadjusted OR 6.2 (2.1\u201318), and unadjusted OR 3.9 (1.6\u20139.5). Prenatal ultrasound scans were evaluated in combined deliveries, of which 48 percent were vertex\u2010vertex at the last ultrasound scan in pregnancy (mean gestational age 34\u00a0+\u00a00) and 37 percent were vertex\u2010vertex at birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Vertex\u2010nonvertex presenting twins have an increased risk of combined delivery. Combined deliveries are associated with increased neonatal morbidity for the second twin. (<jats:styled-content style=\"fixed-case\">BIRTH<\/jats:styled-content> 40:1 March 2013)<\/jats:p><\/jats:sec>","DOI":"10.1111\/birt.12023","type":"journal-article","created":{"date-parts":[[2013,3,14]],"date-time":"2013-03-14T07:09:23Z","timestamp":1363244963000},"page":"10-16","source":"Crossref","is-referenced-by-count":12,"title":["Cesarean Section for the Second Twin: A Population\u2010Based Study of Occurrence and Outcome"],"prefix":"10.1111","volume":"40","author":[{"given":"Line","family":"Engelbrechtsen","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology,University Hospital Roskilde  Roskilde Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elise Hoffmann","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology,University Hospital Roskilde  Roskilde Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trine","family":"Perin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology,University Hospital Roskilde  Roskilde Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Oldenburg","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Copenhagen University  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Tabor","sequence":"additional","affiliation":[{"name":"Medical Consultant in the Department of Fetal Medicine, Copenhagen University  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lillian","family":"Skibsted","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology,University Hospital Roskilde  Roskilde Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Danish Fetal Medicine Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,3,12]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2003.64"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.12.009"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1375\/twin.9.5.685"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2005.08.017"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0756.2008.00976.x"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.04.009"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.06.084"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318187ccb2"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.05.013"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2010.02836.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.325.7371.1004"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000110248.32558.fb"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(01)01597-6"},{"key":"e_1_2_6_15_1","unstructured":"Astraia Software GMBH version 1.21.9 M\u00fcnchen Germany."},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.10057"},{"key":"e_1_2_6_17_1","volume-title":"SAS statistical software","author":"SAS Institute Inc","year":"2000"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2006-954957"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2002.01159.x"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39118.483819.55"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/0029-7844(96)00269-4"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c1471"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200102153440701"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-9-14"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(01)01370-9"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1080\/147670505000132484"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.0004-8666.2003.00056.x"},{"issue":"12","key":"e_1_2_6_28_1","first-page":"767","article-title":"Cesarean section for the second twin","volume":"42","author":"Kurzel RB","year":"1997","journal-title":"J Reprod Med"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318163c435"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02840-3"}],"container-title":["Birth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fbirt.12023","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/birt.12023","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T05:46:39Z","timestamp":1700631999000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/birt.12023"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,3]]},"references-count":29,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2013,3]]}},"alternative-id":["10.1111\/birt.12023"],"URL":"https:\/\/doi.org\/10.1111\/birt.12023","archive":["Portico"],"relation":{},"ISSN":["0730-7659","1523-536X"],"issn-type":[{"value":"0730-7659","type":"print"},{"value":"1523-536X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,3]]}}}