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Recording available 2/16-5/2
Recording available 2/16-5/2
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Poster Session 2

Category: Clinical Obstetrics

Poster Session 2

(517) Fetal Head Station at Second-Stage Onset in Twin Pregnancies and Delivery Outcomes

Wednesday, February 11, 2026
3:30 PM - 5:00 PM  

    Submitting Author and Presenting Author(s)

  • Itamar Gilboa, MD

    Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center
    Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel

    • Coauthor(s)

  • Daniel Gabbai, MD, MPH

    Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center
    Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel

  • DE

    Dana Englander, MD

    Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center
    Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel

  • Itai Atar, MD, MPH

    Resident
    Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
    Tel Aviv, Tel Aviv, Israel

  • YY

    Yariv Yogev, MD

    Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center Gray Faculty of Medicine, Tel Aviv University, Israel
    Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel

  • Emmanuel Attali, MD (he/him/his)

    Head of Maternal Wards
    Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center
    Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel

Objective:

Although fetal head station (FHS) at the onset of the second stage is associated with delivery outcomes in singletons, its role in twin gestations—where only the presenting twin’s station is assessed—remains unclear. This study aimed to evaluate the association between FHS at second-stage onset and mode of delivery in twin pregnancies.

Study Design:

 A retrospective cohort study was conducted at a single university-affiliated center (2013–2024), including women with twin gestations ≥37 weeks, presenting vertex first twin, and planned trial of labor. Only the first twin was analyzed, as fetal head station was documented solely for the presenting fetus. Women were stratified by FHS at second-stage onset: Group A - above ischial spines (S < 0), Group B - at ischial spines (S=0), and Group C - below ischial spines (S > 0).

Results:


  1. Of 496 eligible twin pregnancies, 249 met inclusion criteria

  2. Distribution by fetal head station: Group A – 9.6%, Group B – 30.1%, Group C – 60.2%.

  3. Cesarean delivery (CD) rates were significantly higher in Group A (12.5%) vs. Groups B and C (1.3% each, p< 0.001). Most CDs were due to arrest of descent (66%).

  4. Vacuum-assisted delivery was more common in Group A (25.0%) than in Groups B (12.0%) and C (9.3%) (p=0.032).

  5. Median second-stage duration increased with higher station: Group C: 0.2h (0.1–1.1), Group B: 0.5h (0.2–1.4), Group A: 1.1h (0.2–3.1) (p< 0.001).

  6. No significant difference was observed in non-vertex presentation of the second twin across groups (6.7–10.7%, p=0.315).

  7. On multivariable analysis, fetal head station above the ischial spines was independently associated with a reduced likelihood of spontaneous vaginal delivery (aOR 0.21, 95% CI 0.01–0.9; p=0.030), even after adjustment for relevant maternal and labor-related variables, including second-stage duration.

  8. Among nulliparous women, this association remained significant (aOR 0.10, 95% CI 0.01–0.9; p=0.042).



Conclusion:

In twin gestations, fetal head station above the ischial spines at the onset of the second stage is associated with prolonged second stage and lower rates of spontaneous vaginal delivery.