complications of labour
Last reviewed 04/2023
- malpresentations e.g. in twins
- 45% are cephalic/cephalic
- 39% are cephalic/breech
- 9% are breech/breech
- 5% are cephalic/transverse
- 2% are transverse/transve or breech/transverse
- postpartum haemorrhage - 2.5 fold increase over singleton rate to 10% (1)
- cord prolapse - often in association with malpresentation - increased 6
fold in twins (to 2.3%) (1)
- locked twins - extremely rare - aftercoming head of one twin locked with
forthcoming head of the other - usually requires delivery by Caesarean section
- twin to twin transfusion - placental anastomoses may give rise to growth
discordance or death of one or both twins
- antepartum haemorrhage - studies suggest an increased APH in multiple pregnancies but much of the APH is attributed to unknown origin; a few to placental abruption or placenta praevia
Reference:
- Chamberlain. ABC of Antenatal Care. Multiple pregnancy. BMJ 1991; 303: 111-115.