Fetal presentation and successful twin vaginal delivery

Patients with nonvertex second twins had comparable, if not higher, rates of vaginal delivery than their vertex-presenting counterparts. The higher rate of vaginal delivery with stable nonvertex lie and the association with labor induction and the physician's years in practice all suggest a role for provider selection and delivery planning. These findings and the observed 11% rate of intrapartum presentation change support vaginal delivery of the nonvertex second twin.