Re: Difficult twins

From: Dr Eberhard Lisse (el@lisse.NA)
Sun Dec 31 00:14:28 2006


I do not do vaginal twins no more.

That said, I don't think a podalic version is going to help, and if the outcome is poor this will not endear you to the patient. So, *IMMEDIATE* Section. Sounds a little like abruptio of the second placenta.

What was the outcome?

And, why the induction?

greetings, el

on 12/31/06 2:26 AM Andrew Folley said the following: >
> what do you do???
> On call last night. Induced twins for my partner. G2P1 38 weeks.
> Vertex/vertex di/di. Patient with epidural. First baby comes out 6:00
> pm vacuum outlet assist. no problems. Next baby vertex at -2 cx 5-6
> cm. Of course nurse says heart tones are down in 50-60s. Time 6:05.
> US shows heart rate is low. Mom pushes baby not coming out. AROM second
> twins bag clear fluid. Could not apply vacuum due to membranes, placenta
> from first baby in way etc. 6:08 pm heart tones still down. Nurse
> says can not find heart rate. Mom looks at dad, dad looks at me, I look
> to see if my lawyer has showed up yet. What do you do?????????????????andy





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