Exposures
The exposure was the planned mode of delivery in uncomplicated MCDA twins, which was established before the onset of labor. This was categorized as PCS or TOL, including spontaneous vaginal vertex deliveries, assisted vaginal birth (forceps, Thierry’s spatula, and ventouse deliveries), breech extraction of the second twin, and emergent cesarean section. Breech extraction was performed in MCDA twins when gestational age at delivery was 32 weeks or greater, in the absence of a previous CS, and intertwin weight discordance was less than 15%.
In case of induction of labor, PCS, or breech extraction, informed consent was provided and explained, detailing the risks and benefits of each technique.