Normal childbirth is different from the birth of the twins, at birth, the twins may experience various complications, even if the pregnancy was completely normal. Childbirth double happiness often begin a little earlier than usual, and by the time last longer. Birth of twins can usually begin at 37-38 week from the moment of conception, and triplets at 34-5 week. If a woman is pregnant is not one child, but several, she should be under the close supervision of medical staff. The most dangerous periods in the third trimester – 29-32 week, when the twins a period of 36 weeks, when the triplets from 34 weeks until childbirth. During these periods, for women it is best to stay at the hospital.
If the birth of the twins don’t have any complications, they started no different from an ordinary birth – the first regular contractions. When the period of labour is coming to an end, it breaks the fetal bladder and water depart. Then time begins futile, first born twin. When the first baby is born, the doctor is bandaging the end of the umbilical cord of the mother and the umbilical cord of the fetus. If this is not done, then the second fetus can open a big bleeding from the loss of large amounts of blood he may die, because the twins General circulation. After ten or twenty minutes after the birth of the first baby again begin contractions of the uterus, the second SAC, too, breaks, water depart, and the second born of twins.
The most frequent complications are twins: premature detachment of the placenta second baby after the birth of the first, weak parturition, premature pouring out of the amniotic fluid, loss of some parts of the first child (pen, stalk), late rupture of membranes second child, asphyxia and hypoxia one or two (three, and so on) children.
Incorrect position of one of the fetus or previa
Basically until labor twins take in the uterus longitudinal position (this applies to 99 % of the cases). About 65% of twins are when it heads to the bottom. Each of the children can be frontal presentation, facial and parietal. Close to 30-35% of twins are in mixed-pelvic head previa, that is, one baby is head down and the other up. Very rarely, about 5 % of cases, the twins can take pelvic position. Only 1% of children – twins can be placed in the mother’s belly across. If the first baby is in the parietal position, and there is no emerging pathologies, childbirth can be the natural way.
Incorrect position of one of the fetus or previa twins
If children are in the frontal or front position, it is recommended to perform a caesarean section. In case of pelvic-personal presentation babies determining factor is the position in which the first child. If it is in the parietal or foot position, you can have a natural childbirth. In all other cases, the method of birth of the children is determined by the physician. His decision depends on the course of labor and the condition of the mother. If the second child is a foot or parietal position, the second the baby is born also in a natural way. If the second child is in an oblique or transverse position, and when the front previa pivot on the leg. If the doctor can’t do it, then immediately made a decision about caesarean section.
Across the maternal abdomen kids can also be different:
both of the child can be located in a transverse position.
one child may be in an oblique position (or transverse), and the other in the pelvic presentation, in a longitudinal position.
– one child in the head previa, in the longitudinal position and the other in an oblique (or transverse) position.
At birth twins can be such a serious problem, as the collision fetus, clutch, tapered implementation (block) of the fetus. In this case, both of the kid in the leg or in the head previa begin to get into the birth canal. Such cases are very dangerous for the mother of the child, and for the baby, they can die in this case, therefore, the physician performs a caesarean section.
Weak labor activity
The woman, who bears more than one child may be weak labor activity. This is associated with a significantly increased size of the uterus and its great strength. The weakness of labor activity prolongs the duration of the first, and sometimes second stage of labor. If two kids are in longitudinal position, they can be born naturally.
Creating and carrying twins in the womb
Premature detachment of the placenta
The birth of the first twin, the uterus contracts, and this may cause placental abruption second baby. Detachment of the placenta may have a consequence for a second child, as hypoxia, that is, oxygen starvation. Therefore, doctors do everything possible for the baby as soon as possible passed through the birth canal. Often spend amniotomy, it is made with renewed combat. This often allows you to stop the detachment of the placenta is at the entrance of the head of the baby in the pelvis of the woman, loose part is pressed, and childbirth are natural way.
Premature outpouring of amniotic fluid
If a woman carries one child, fetal membranes are terminated prematurely due to infections of the genital and urinary systems. If a multiple pregnancy, the amniotic fluid in the main leak due to a significant increase in the uterus. If such symptoms occur, the doctors are doing everything to prolong pregnancy. Pregnant assigned to bed rest, preferably in a hospital and under strict medical supervision because they can begin preterm birth. In case of maturity of the lungs twins, can be caused by artificial childbirth or scheduled cesarean section.
the Loss of small parts of the first child when carrying twins
If the first fetus is transverse or oblique position, and once broken fetal membranes and poured water can drop leg or handle of the child. If the fetus had the pen, then doctors often conduct caesarean section. If, however, had the leg of the baby, can be performed obstetric rotation on the leg, as it proves convenient position for birth, the fetus is in a position closer to the foot.
Late rupture of membranes
When the first twin is born and again resumed birth pains, under normal circumstances should begin to break the second SAC. But it frequently happens that a second child with fetal bladder is pushed through the birth canal is very slow, this is due to pererasseyaniya of the uterus. If such a delay occurs, you may have serious complications. Doctors carry out in this case, amniotomy to accelerate the birth of the second child.
Asphyxia and hypoxia when carrying twins
When multiple pregnancy childbirth lasts much longer than the birth of one child. This can lead to hypoxia, anoxia children. This danger is particularly exposed to the second child. The umbilical cord may fall, also during the passage of patrimonial ways kid can turn the umbilical cord and there is a lack of oxygen. If the placenta pulls away prematurely, you can also develop anoxia. If the uterus in normal activity, with the aim of reducing the time of childbirth may apply for the birth of the first baby forceps. If a child becomes entangled in the umbilical cord, or she falls, tor it can cause asphyxia (suffocation) baby. To avoid this, at the slightest sign of entanglement child’s umbilical cord, carry out an emergency caesarean section.
In some cases, carry out a caesarean section when the twins?
Many believe that the twins are born only by caesarean section. But this is not the case, half of twins are born in a natural way. But if you still have indications for cesarean section, it is not necessary to insist on the carrying out of natural childbirth. In any case shows a caesarean section?
Pregnancy after infertility. If children after infertility conceived naturally or with IVF, they are for mother, and for doctors to be very valuable. In this case, the doctors will make every effort to ensure that childbirth had a positive outcome. And to be safe and to avoid possible complications, perform a caesarean section.
Low weight babies. If twins weigh less than 1700 grams each, there is a great risk that they during natural childbirth can be given birth trauma. And to avoid this situation, doctors prescribe surgery cesarean section.
Many complications during pregnancy children or during childbirth. Pregnancy two kids (and more) has some risk for children and for the mother. This pregnancy is usually a lot more complications than normal pregnancy. If the pregnancy was hard, and especially if the woman was on preserving, then it is better to assign a surgical intervention for the birth of children.
If a woman already give birth by caesarean section. In this case, the question of the possibility of natural childbirth automatically disappears. But still there are some exceptions, when after caesarean section women themselves gave birth to two children.
If kids are in breech or transverse presentation. If two children are in the pelvic previa or at least one child is in the pelvic previa (the one that appears first), then in that case, be sure to perform the operation. If children are in position “j”, and the second baby is in the pelvic presentation, it is likely that he will turn over, immediately after the birth of their first child.
The future mother of twins must understand that for multiple births use a very large number of different drugs, so do not be afraid of this. Often used painkillers, drugs that eliminate spasm, is the prevention of oxygen deficiency (hypoxia) children, monitor blood pressure.