12 - Obs - Multiple Pregnancy - Intrapartum MGMT

Question 1

Mode of Delivery
? ? incr used for all twins. Due to incr risk of ? and ? in 2nd twin vs first. C sec indicated if 1st twin ? or ? (20%), with high orders, if any ? compx and all ?? twins. ? deliv of 1st twin when ?, no matter lie/presx, remains common and is discussed

Answer 1

C/S
death
hypoxia
breech
transverse
antepartum
MC
vaginal
cephalic

Question 2

Method of delivery

?, or c sec, usually 37-38wks (??) or 34-37 (??), after which perinatal ? is incr. ??? advised as risk of intrapartum ? is incr, esp for 2nd twin. ? analgesia helpful if difficulty w ?nd twin. First twin delivered ?.
? can diminish after 1st twin. Usually return within a few ?– ? started if not.

Answer 2

induction
DC
MC
mort
CTG
hypoxia
epidural
2nd
normally
contractions
mins
oxytocin

Question 3

Method of Delivery

? of 2nd twin checked and ??? done if not longitudinal. Once head/breech enters ?, membranes are ? and pushing again begins. Delivery usually easy if ? or ?, and done within ?mins of 1st twin. Excessive delay ass w incr ? for 2nd - excessive haste ? dangerous. If head doesn’t descend, ? likely and ? ? may be needed. If fetal ? or cord ?, vaginal delivery can be expedited w ? or ? ?

After delivery, prophylactic ?
infusion to prev PPH

Answer 3

lie
ECV
pelvis
ruptured
cephalic
breech
20
morb
equally
malpresentation
c/s
distress
prolapse
ventouse
breech extraction
oxytocin