Indications of urgent delivery of the second baby in twin are all except:
Correct Answer: Breech presentation of the second baby
Description: The interval between delivery of twins should be less than 30 minutes. If there is a delay of more than 30 minutes, interference should be done..
But there are some conditions in which urgent delivery of the second baby is required – Indications of urgent delivery of the second baby: (1) Severe (intrapartum) vaginal bleeding (2) Cord prolapse of the second baby (3) Inadvertent use of intravenous ergometrine with the delivery of the anterior shoulder of the first baby (4) First baby delivered under general anesthesia (5) Appearance of fetal distress.
Management: In all these conditions, the baby should be delivered quickly. A rational scheme is given below which depends on the lie, presentation and station of the head.
Head
–– If low down, delivery by forceps
–– If high up, delivery by internal version under general anesthesia.
Breech should be delivered by breech extraction
Transverse lie—internal podatic version followed by breech extraction under general anesthesia.
If, however, the patient bleeds heavily following the birth of the first baby, immediate low rupture of the membranes usually succeeds in controlling the blood loss.
Remember:
The only indication for internal podatic version these days is:
Second twin transverse lie
Category:
Gynaecology & Obstetrics
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