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Twin delivery is often complicated by breech presentation of the second twin. To investigate the influence of breech presentation of the second twin, we reviewed all 259 twin deliveries from the 18,404 deliveries at our institution over 11 years between 1978 to 1989. The neonatal morbidity of the second twin in breech presentation (pH less than 7,15; 1-minute-Apgar less than 7, transfer to newborn hospital) was significantly higher in comparison to vertex presentation of the second twin. A dependence of neonatal morbidity on the time interval was not found. Where the second twin was in vertex presentation, a higher neonatal morbidity rate with increasing interval was seen. No significant differences were noted for neonatal morbidity between vaginal and caesarean delivery by breech presentation to the second twin.
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