DefinePK

Abstract

Trial of labor (TOL) in twin pregnancies is becoming a common practice and the success of vaginal delivery depends on the parity of the mother and the presentation of the twins. When TOL is attempted in twin gestation there is a possibility of normal vaginal delivery of the first twin and need for CS to deliver the second twin (Combined delivery- CD). This may be due to non-cephalic presentation, failure of progression and fetal distress of the second twin. When the patient presents with CD the main challenge for the anesthetist is to decide the plan of anesthesia (General anesthesia versus spinal anesthesia). It is ideal to restrict the time interval between the delivery of the twins to less than 30 min. We would like to share our experience in handling two patients with twin geststion who underwent TOL and required emergency CS for the delivery of second twin following normal vaginal delivery of the first twin.