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Summary. Twin pregnancies delivered after 28 weeks gestation between 1980 and 1988 were reviewed. Of 510 twin pregnancies, 184 (36%) were delivered by caesarean section. There were 22 (4.3%) combined vaginal/abdominal deliveries which comprised 12% of the 184 twin pregnancies delivered by caesarean section. Persistent transverse lie or a high breech presentation was the commonest indication for caesarean section for the second twin.