Cesarean section for all twins?

Abstract

Twin gestations frequently involve maternal and fetal complications, and are quite often considered as "premium" pregnancies. Hence, many clinicians that follow the cliche "no high risk pregnancy should end with a high risk delivery" may deliver twins by CS for many subtle reasons, other than clear-cut, evidence-based, indications. Thus, the decision for a CS in twins, intentionally or not, is based on qualitative variables that were not quantified and on quantitative variables that suggest no advantage for CS in the majority of cases.