Management of twin pregnancy in labour, which of the following is true?
Delivery of second twin No methergin after delivery of first twin. This is a classic contraindication for methergin since this drug will cause severe tonic contraction of the uterus on the fetus which compromises the fetal blood flow and hence Hypoxia First twin in non-cephalic presentation is an indication for LSCS IPV (internal pdalic version) may be done for second twin if it is in transverse lie First twin cephalic and second twin breech can be tried for normal labour Indications for LSCS in twin pregnancy: first twin non cephalic, monoamniotic twins Indications for LSCS for second twin ( Even if the first baby delivered vaginally): fetal distress, failed IPV, abruption, cord prolapse
Inj methergin should be given after delivery of first twin as a large uterus is at increased risk of developing PPH
External cephalic version can be attempted at 36 weeks if first twin is non-cephalic
Internal podalic version can be done for second twin if it is in transverse lie
First twin cephalic and second twin breech is a contraindication for trial of normal labour
Twin Pregnancy, Molar Pregnancy, Gestational Trophoblastic disease and contraception in special situations (Sour Grapes!)