Abstract
“Locked twins” is a rare event occurring in about 1 in every 1000 twin births. A 21-year-old primigravida with a 31-week twin pregnancy was admitted for delivery. The head of the first twin was locked to the chin of the second twin at the top of the symphysis pubis. Caesarean section was performed allowing the delivery of both dead twins. Twins gestations with first twin in the breech presentation raise index of suspicion of potential locked twin. However, management of such situation is controversial with most authors and colleges recommending caesarean section to avoid interlocking heads. We report another rare case of interlocking heads and bring up the topic about management of breech-first twin deliveries.
Highlights
Multiple pregnancies have increased for the last three decades due to a growing use of assisted reproductive techniques and the rise in maternal age [1]
Jan. 22, 2021 appreciated according to the mode of delivery. This is due to the fact that, currently, no consensus exists regarding the optimal mode of delivery for twin gestations with breech twin A
We report a new case of interlocking twins managed by caesarean section
Summary
Multiple pregnancies have increased for the last three decades due to a growing use of assisted reproductive techniques and the rise in maternal age [1]. In around 20% of these pregnancies, the first twin is in breech presentation [3] whose delivery management is controversial. Caesarean section was performed for the risk of interlocking twins during childbirth of breech-vertex twins. We report a new case of interlocking twins managed by caesarean section. We managed to extract the head of the second twin which was in the pelvic excavation and extract it by cephalic enucleation This was a fresh, female stillborn weighing 1275 g. We proceeded to the delivery of the first twin, a fresh stillborn male weighing 1980 g This was a dichorionic diamniotic twin pregnancy with the placenta being formed of two partially fused placentae
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