Vaginal delivery can be allowed in all except (AIIMS May 2011)
|A||Monochorionic, monoamniotic twins|
|D||Dichorionic twins with first vertex & second breech|
Monochorionic, monoamniotic twins
a. In TWINS, Route of delivery is decided by the position of first baby.
b. Only if the first fetus is in vertex position, then normal vaginal delivery is possible.
c. Twins with first fetus in nonvertex position (breech, transverse, oblique,…) are to be delivered by LSCS.
d. MC, MA twins are always to be delivered by LSCS (even if the first fetus is in vertex position) because of very high risk of cord prolapse.
e. In mento anterior face also vaginal delivery is possible .
f. Breech with extended limbs (frank breech) also vaginal delivery is possible