Locked twins

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Locked twins
SpecialtyObstetrics

Locked twins is a rare complication of

stillborn
.

Description

There are two types of locked twins: breech/vertex and vertex/vertex. In breech/vertex presentations, which are much more common, the first twin is in the

birth canal, preventing vaginal delivery.[3] In vertex/vertex presentations, where both twins are positioned for head-first delivery, the two heads become locked at the pelvic brim, preventing either fetus from passing through the pelvic inlet in a vaginal delivery.[2]

Contributing factors to the interlocking of twins include uterine

primigravidae (young women in their first pregnancy), and pregnancies with monoamniotic twins.[1]

Management

If locked twins are diagnosed in early delivery, before either twin is born, both fetuses can be delivered by

forceps.[4] If the diagnosis is made only after the first locked twin has died in the birth canal, or if it is not expected to survive, the first twin may be decapitated and its head pushed up to allow safe delivery of the second twin.[2][4]

At least one case has been reported where hexoprenaline was used to relax the uterine smooth muscle to thereby temporarily inhibit labour and disimpact the fetal heads.[1]

Outcomes

Since locked twins are often diagnosed in the late stages of delivery, it is often too late to intervene to save the life of the first twin and thus there is a high rate of stillbirth, estimated to be over 50%.[1][5]

References

  1. ^
    PMID 23439954
    .
  2. ^
    ISBN 9789350255575
    .
  3. ^
    ISBN 9780781762496
    .
  4. ^
    ISBN 9780702164026
    .
  5. ISBN 9788172252328
    .

External links

Retrieved from "https://en.wikipedia.org/w/index.php?title=Locked_twins&oldid=1188109555"