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Complications of labour

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • 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.

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