For multiple fetal pregnancies, an assessment of the method of delivery is made at 35-36 weeks of gestation if pregnancy has been regular. If any condition or change requires earlier evaluation, the method of delivery is assessed on a case-by-case basis.
About half of twins are normally born with a low birth rate. Of all twins, one in three initially intended to be born at the lower end will undergo caesarean section during childbirth, for either maternal or fetal reasons. One fifth of twins are born with a pre-planned caesarean section. Sometimes, rarely (0.7 percent), the first baby (baby A) can be born underneath, but baby B has to be helped out by a caesarean section. The reason for this is the imminent plight of baby B, which has arisen since baby A was born and was unpredictable.
A planned caesarean section is appropriate if the mother’s pelvic dimensions are not sufficient, for example, to give birth to an anterior infant, or if the mother has previously had more than one caesarean section. Caesarean section is also performed if the fetus (s) during pregnancy have been diagnosed with a problem that is estimated to impair fetal well-being during contractions, or the mother’s fear of childbirth prevents miscarriage.
How does the supply of fetuses affect the method of delivery? If the A-fetus is head-down, ie in the rumen supply (RT), under-delivery is preferred first. The position of the B-fetus does not matter.
In the case of an A-fetus in the sternum (PT), under-delivery may be considered on a case-by-case basis, especially in the case of a newborn, and the mother herself is motivated by under-delivery. About 20% of twin pregnancies have a miscarriage of A fetus at the end of pregnancy. According to international studies, under-delivery is the preferred option if there are otherwise good conditions for under-delivery.
If both fetuses are in the foreskin, the most common method of delivery is a caesarean section. If you have all the other good conditions for a low birth and the spontaneous onset of childbirth can occur, you may end up with a lower case.
If the A-fetus has a head other than the head or at delivery, the delivery will always be caesarean.
Treatment of childbirth All childbirths of monochorial twins are treated in the HUS district at the Women’s Clinic. Dicoriacal twins can be born at any birth hospital chosen by the family.
The treatment for the opening of childbirth is the same as for single-birth pregnancies. In the twin delivery phase, 1-2 doctors are always present in addition to the two midwives. This ensures that children are born as safely as possible in the event of problems in the effort phase. During childbirth, the heart rate of both fetuses is monitored. If follow-up reveals signs of distress in either fetus, it is possible to proceed to caesarean section at any time during delivery. A-fetus is born just like a single-fetus pregnancy. After the birth of A, another physician often supports the position of the B-fetus over the mother’s stomach and, if necessary, guides her to the longitudinal delivery, either head down or stern. The support prevents the B-fetus from changing position after this. According to the literature, up to 20 percent of B-fetuses change position after A is born without attachment.
After the birth of A, the uterus is expected to start shrinking again. The uterus often rests for a moment. B-fetal well-being is monitored continuously. Usually, at this stage, the oxytocin hormone is initiated to support uterine contraction. At this stage, the supply and heart rate of the B-fetus can be examined using ultrasound. When the contractions begin again, the mother may struggle if the tender portion of the B-fetus is already low enough. If the B-fetus shows signs of distress, birth can be accelerated with a suction cup-out vehicle or by pulling out a baby in the aft. If the birth interval threatens to extend beyond one hour, you can go to the operating room and have a B-fetus withdrawn. However, this is rare. Occasionally, a caesarean section may also result if the supply of the B-fetus is unfavorable and prevents lower birth or B-fetal impairment and there is no possibility of suction cup / sternal extraction.