External cephalic version of twin A

Background: When a first twin presents as a breech, cesarean delivery is generally recommended, Vaginal delivery of the first twin as a breech has also been described. However, the option of external cephalic version of the first twin, followed by vaginal delivery, is rarely considered. Cases: We report two cases in which twin A presented as a breech, one at 36 and one at 38 weeks' gestation. In each case, external cephalic version of the first twin was successful, with subsequent vaginal delivery of both twins. Conclusion: External cephalic version of a malpresenting first twin is a management option that can result in successful vaginal delivery. (C) 1997 by The American College of Obstetricians and Gynecologists.