Evid Based Med 19:119 doi:10.1136/eb-2013-101655
  • Practice guidelines
  • Randomised controlled trial

Caesarean delivery for twin gestation at 32–38 weeks does not lead to improved clinical outcomes for neonates or mothers

  1. Yair J Blumenfeld2
  1. 1Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA;
  2. 2Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, USA
  1. Correspondence to : Dr Henry C Lee, Department of Pediatrics, Stanford University School of Medicine, 750 Welch Road, Suite 315, Stanford, CA 94305, USA; hclee{at}

Commentary on:


Use of caesarean delivery (CD) for twin gestation has increased dramatically worldwide in recent years.1 ,2 Although some observational studies have suggested that there may be decreased risk of adverse perinatal outcomes with CD, clear benefits of routine CD for twin gestation have not been established, especially when the primary provider is experienced in breech extraction of the second twin.3 This large multicentre trial aimed to avoid the biases of observational studies in order to answer the question of optimal delivery mode for twin gestation.


This was a randomised, unblinded clinical trial occurring at 106 centres in 25 countries from 2003 to 2011. Inclusion criteria …

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