Locked Twins: A Rarity
An unbooked primigravida aged 31 years was admitted to the labor room with arrested after-coming head of breech. The patient was not aware of her last menstrual period. On examination, her vitals were stable. Per abdominal examination revealed uterine fundal height of 28 weeks’ size and a fetal heart rate of 136 beats/minute, auscultated just above the level of the umbilicus. No heart sound was found for the first baby. Vaginal examination showed the head of the second baby []. It was then realized that the head felt above the symphysis pubis was that of the first twin. As the locking was so tight and the second baby's fetal heart beat was still present, lower segment caesarean section (LSCS) was performed in the interest of the surviving baby. After disimpaction of the head vaginally, the second baby weighing 1.2 kg was delivered abdominally by breech. The baby was then handed over to the pediatrician. The first baby weighing 1 kg, which was already dead, was delivered vaginally. Placental examination showed it to be a monochorionic diamniotic twin. The second baby was discharged after 2 weeks of observation in the pediatric intensive care unit. The mother had an uneventful post-operative stay in the hospital and was discharged subsequently. The patient was seen in the postnatal clinic 6 weeks later. She was well with healed abdominal wound and involuted uterus.