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The twins or twins are usually placed inverted, facing each other, to gain space within the uterine cavity. One is usually placed in a cephalic position and the other in a breech or breech position. In 75-80 percent of cases, one of the twins or twins is usually in a cephalad position and therefore spontaneous vaginal delivery is possible.
But twins or twins can also adopt other postures: both breech, both in a cephalic position or both in a transverse position, which will determine whether the delivery will be natural or by cesarean section.
In multiple births, a gynecologist and / or midwife, an anesthetist and a neonatologist are usually present to assess the babies at birth. The second twin or twin must be born within twenty minutes after the birth of the first, although it is estimated that the second baby can be born 3 to 45 minutes after the first baby. In the event that the second baby has not been born within this period of time, the gynecologist or midwife should intervene, especially if they detect fetal distress or lack of progress.
Among the possibilities of action for the extraction of the second baby are the internal version and the extraction of the breech; the sucker, if the presentation is cephalic, but is high; extraction with forceps if the head is engaged; breech extraction and cesarean section.
In twin or twin pregnancies, it is common for babies to be smaller and weigh less than babies who have grown up in a single pregnancy. Being smaller in size than other babies, its vaginal delivery is easier than in a single fetus delivery. For this reason, it is advisable that the maternity or hospital is prepared to provide care for premature babies.
The choice between cesarean section or vaginal route in multiple births it depends on several factors:
1. From the moment when labor begins, since if it is very premature, it is not possible to do it vaginally.
2. On the position of the fetuses.
3. Whether there is fetal distress in one of the two or in both.
4. On the existence of other complications ...
There are two kinds of twins: identical ones and twins. Identical twins are produced by the division and development of a single egg fertilized by a single sperm. Consequently, they almost always share the same placenta, although each has its own umbilical cord and amniotic sac, and this is an important feature for decision-making in labor and delivery.
Twin twins are the result of the fertilization of two different eggs by two different sperm. Therefore, they have different placenta, different umbilical cord and different amniotic sac.
However, by developing at the same time in the same uterus, they quickly occupy the available space and, for this reason, are more exposed to being born prematurely or prematurely, that is, before 37 weeks of gestation or to complications arising in pregnancy such as preeclampsia or diabetes.
Cephalic position both. 41 of the twin or twin babies are positioned like this at birth. It is the most common position and the ideal position to be born: both head down. Delivery can be done vaginally. When both babies are head down, there is less chance of birth complications.
Cephalic position of only one. In this position, we must distinguish between two versions. When the first baby presents the cephalic position, which occurs in 21 percent of cases, it is possible to deliver vaginally with all the guarantees, even if the second baby is not in the cephalic position, but in the breech position. In this case, vaginal delivery is also possible, as the baby that is in the cephalic position (head down) will be born first, opening the way for the other. This is turned or born breech, which is generally not a problem, since it has a lot of space.
On the other hand, if the first baby is breech, as is the case in 16 percent of cases, it will surely be necessary to resort to a cesarean section.
Transverse position. If the first is breech and the second baby is in a transverse position, as is usually the case in 4 percent of cases, the solution is to resort to a cesarean section, the most common method for multiple births. It may also happen that the first is in a cephalic position and the second in a transverse position, a more common position that occurs in 8 percent of multiple births. In this case, cesarean section is also usually used, although if the babies are not large, the second baby can be turned after the first is born.
Position breech. When both babies are breech, as is the case in 10 percent of cases, in general, a C-section is usually done, after assessing the risk. Cesarean section is also indicated when the first baby is breech (as in the photograph), even if the second is in the cephalic position.
Triplets, quadruplets or quintuplets. They are rare. There were a few years in which they increased due to the implantation of several embryos in fertility treatments, although now it is more controlled and it is only allowed to put 2 to 3 embryos at a time. These pregnancies occur for the same reasons as twin pregnancies, and the babies can be identical, twins, or a combination of both. In these pregnancies it is not advisable to contemplate a vaginal delivery. C-section is the best option.
You can read more articles similar to Babies' positions in multiple births, in the category of Delivery on site.