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Pregnancy Bliss | Reproductive Health Hub

This Indian gentleman, Sanju  Bhagat, carried the body of his twin inside his abdomen before the diagnosis of fetus in fetu was made almost 40 years after his birth. Fetus in fetu is very rare

Probability Fertility drugs Identical Vanishing twin TTTS Twin delivery Fetus in fetu Twin death

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What is locked twins?

This is a rare complication (historical incidence 0.1 per cent) which may occur if Twin 1 is breech and Twin 2 is leading with a head. It is probably only of historical importance as, nowadays, virtually all twins presenting as such are delivered by caesarean section.

What is ‘fetus in fetu’?

This is an exceedingly rare complication of twin pregnancy in which one twin literallSanju Bhagat; fetus in fetuy absorbs the other. The absorbed twin will therefore appear in the form of a calcified mass of tissue usually in the abdominal cavity of the other twin. It is possible to recognize this through ultrasound scanning before delivery.  The mass of tissue will usually be removed surgically in infancy.


Delivering twins

What is the likely method of delivery for twins?

Barring any other complicating factors, the general rule for twin delivery is that, if Twin 1 or both twins are leading with the head, then delivery should be normal vaginal. The leading part of Twin 2 is usually irrelevant. However, if Twin 1 is leading with any other part (other than the head), then caesarean section is usually the method of delivery, regardless of what Twin 2 is leading with. There are circumstances where this general rule will not apply and which the obstetrician should discuss fully with the prospective mother.

If I am carrying triplets, what is the likely method of delivery?

Caesarean section. There are some countries in continental Europe and Africa where vaginal delivery in some selected cases of triplet pregnancy is advocated and practised. In the UK and many other parts of the world, the only accepted method of delivery for triplets - and indeed other higher ­order multiples - is caesarean section. This is because they have a higher incidence of prematurity and growth restriction. This makes them more prone to such problems as fetal distress.

It is not possible to continuously electronically monitor all three during labour and therefore distress in one or more of them may go unrecognised.

What is the acceptable interval of delivery between Twins I and 2 in vaginal delivery?

One hour. Most will be delivered within thirty minutes of each other. Beyond this it may be necessary to stimulate the uterus to expedite delivery of the second twin.

However, the operative word here is "acceptable" and it applies to the obstetrician. Most obstetricians feel that after one hour, vaginal delivery of Twin 2 is unlikely and probably waiting longer poses some risk to this baby. It is also true, however, that in the presence of satisfactory monitoring of the baby's condition and if the mother so wishes, a much longer interval can be allowed. Twins have been known to be born several hours apart with no undue consequences to Twin 2. Probably the most famous is the pair born on two different days of two different years, Twin I on 31 December and Twin 2 on January 1.

There is no cast-iron rule in this, as long as safety measures are not flouted.

Are there any potential complications after delivery of twins?

Mothers who have delivered twins are at an increased risk of heavy blood loss (postpartum haemorrhage or PPH) after delivery. Measures are therefore routinely taken to minimize this risk.

Twins sound like a catalogue of bad news

It tends to come across as such but it is not. Try to see the bigger picture. Over 85 per cent of mothers with twin pregnancies go home with not one, but two perfectly normal bundles of joy.

Last update: February 21, 2013

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