Most people think that twins should be delivered by caesarean section, but in fact, many twin pregnancies can be born smoothly. Director Zhu Jiwen, an obstetrics and gynecology expert in our hospital, once helped the mother of twin pregnancies to successfully deliver the fetus through the way of normal delivery. Today, we will specially invite Director Zhu Jiwen to talk about the knowledge of twin pregnancy and smooth delivery.
What are the advantages of choosing a vaginal birth for twin pregnancies?
Director Zhu Jiwen pointed out that vaginal delivery is a natural birth, which has many advantages for both the mother and the fetus. For the mother, after vaginal delivery, the woman recovers quickly and has less trauma; For the fetus, through uterine contraction and birth canal squeeze, the alveoli of the fetus after birth are opened, which is convenient for the newborn to quickly establish spontaneous breathing.
However, it should be emphasized that twin births are more complex than singletons and need to be evaluated.
Under which cases can a twin pregnancy be eligible for a vaginal birth?
Director Zhu stressed that the delivery of twin pregnancies needs to be combined with comprehensive judgments such as twin type, fetal orientation, fetal weight, maternal condition and the level of delivery institutions to decide whether to choose a normal birth.
Twin type
Double chorionic double amniotic sac twins
Both fetuses have independent placentas, as long as there is no comorbidities during pregnancy, the first fetus is the head position at the time of delivery, and the double chorionic double amniotic sac twins can choose vaginal trial delivery.
Single chorionic double amniotic sac twins
Two fetuses share a placenta, due to the presence of blood vessels that match each other between the placenta, can lead to the occurrence of special complications of single chorionic twins, and acute twin transfusion syndrome may also occur during delivery, therefore, for single chorionic double amniotic sac twins without comorbidities, the first fetus at the time of delivery is the head, you can choose to have a medical unit with neonatal treatment ability, under close supervision of vaginal trial delivery.
Fetal orientation
Scenario one
Both fetuses are cephalic and double chorionic double amniotic sac twins, which is the best fetal orientation for vaginal delivery.
Scenario two
In the double fetus, the first fetus is the cephalic position, the second fetus is not the cephalic position (such as breech position, transverse position), if there is no contraindication, vaginal delivery is also feasible, if necessary, external inversion and gluteal traction, internal reversal and other vaginal midwifery.
In addition, it is important to note that there is a need to strengthen maternal monitoring during vaginal delivery, especially the management of the second stage of labour, in order to reduce the risk of intrauterine distress and neonatal asphyxia in the second twin fetus.
Preparing for a normal birth, what are the precautions for expectant mothers during pregnancy?
1. Pay attention to rest, appropriate activities, avoid exertion and strenuous exercise, especially after 28 weeks, because the uterus of the twins is obviously enlarged and prone to premature birth.
2, balanced nutrition, more should be supplemented with calcium and iron. Do a good job in the psychological and physical management of pregnancy, and build confidence in natural childbirth.
3. Select a medical institution with experience in twin diagnosis and treatment for regular obstetric examination. Pay attention to communicating with doctors and listen to their professional guidance. Once a pathological condition occurs, it is treated in a timely manner under the guidance of a doctor.
Director Zhu suggested that the delivery of twin pregnancies requires doctors to formulate corresponding birth plans according to the mother and fetus conditions, and it is necessary to have experienced obstetric experts and midwives to jointly observe the delivery process, and a neonatologist needs to be present to deal with the newborn during childbirth, and it is necessary to monitor the fetal heart rate changes of both fetuses at the same time during childbirth, so the vaginal delivery of twins should be implemented in professional midwifery institutions, and patients and families need to fully communicate and communicate to jointly decide the mode of delivery.