Obstructed labour due to locked twins

Nutrition and obstructed labor

“…Although there are many other causes of obstructed labor (18)(19)(20)(21)(22)(23), their contribution is small compared with that secondary to disproportion, and they are nonnutritional in origin.…”

Death by twins: a remarkable case of dystocic childbirth in Early Neolithic Siberia

“…While very rare, occurring in less than 0.15 per cent of twin births, fetal mortality associated with interlocking is estimated at between 30 and 50 per cent if a Caesarean section is not performed (Cohen et al 1965; Kahunda 1972; Rydhstrom & Cullberg 1990; Kurzel 1998; Nassar et al 2004; Carroll & Yeomans 2006; Borah & Das 2012). If the first infant is partially delivered, as appears to have been the case here, manual manipulation such as the Kimball-Rand manoeuvre (Kimball & Rand 1950) may allow for vaginal delivery, but with a high risk of maternal tissue damage (Bowman 1983). In fact, in many modern cases, interlocked twins can only be delivered vaginally if the cranium of the first (deceased) infant is perforated and/or removed, and the birth of the second infant is assisted with forceps (Gordon 1956; Bowman 1983; Kurzel 1998).…”

“…If the first infant is partially delivered, as appears to have been the case here, manual manipulation such as the Kimball-Rand manoeuvre (Kimball & Rand 1950) may allow for vaginal delivery, but with a high risk of maternal tissue damage (Bowman 1983). In fact, in many modern cases, interlocked twins can only be delivered vaginally if the cranium of the first (deceased) infant is perforated and/or removed, and the birth of the second infant is assisted with forceps (Gordon 1956; Bowman 1983; Kurzel 1998).…”