Vaginal twin delivery: a survey and review of location, anesthesia coverage and interventions

The more the merrier: should anesthesiologists be present for multiple births?

“…In this issue of the International Journal of Obstetric Anesthesia, Carvalho and colleagues report their retrospective analysis of vaginal twin deliveries at their institution and the results of a survey of anesthesiologists in California. 9 In their hospital, all vaginal twin deliveries are performed in the operating room with an anesthesiologist in attendance; anesthetic interventions involved 27% of the women; most of these were related to improving epidural analgesia, with only 6% related to providing anesthesia for emergent cesarean delivery. The survey portion of their report confirmed the lack of consensus regarding anesthesiologists' physical presence at vaginal twin delivery; the anesthesiologists' presence correlated with the delivery being conducted in an operating room, but surprisingly not with the hospital type or location, presence of dedicated obstetric anesthesia coverage, or the annual delivery rate of the institution.…”