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PubMed1993

[Importance of abnormal fetal presentation of twins during labor and delivery].

Utilizing the 18 year material of two institutions, the author investigated the effect of fetal lie and presentation on the labor and delivery process. Out of 541 pairs of twins, in 299 instances (55.27%) at least one of the fetuses occupied a transverse lie or presented by the breech. In the remaining 242 pairs (44.73%), both fetuses presented by the vertex. In association with premature labor, out of 239 sets of twins, in 134 instances (56.07%), the presentation of at least one of the twins was abnormal. The same phenomenon occurred in 165 out of 302 pairs (54.63%) when labor set in at term. The percentual frequency of abnormal presentations appeared to be positively related to maternal age and parity. In connection with abnormal presentations, there was an increase in the rate of cesarean sections (38.13% versus 13.21%) and that of low Apgar scores (18.18% versus 9.3%), as compared to those cases where both fetuses presented by the vertex. Of all cases of perinatal mortality, 57.76% involved twin pairs with abnormal presentation versus 42.24% for cases where both fetuses presented by the vertex.

Breech Presentation↗
PubMed1999

Combined maternal and congenital myotonic dystrophy managed by a multidisciplinary team.

Myotonic dystrophy is a rare autosomal dominant degenerative neuromuscular and neuroendocrine disease. Pregnancy can aggravate the maternal disease. Obstetrical complications include stillbirth, premature labor, polyhydramnion, abnormal presentation, prolonged labor, increased operative delivery, postpartum hemorrhages and anesthetic accidents. If the fetus is affected severe neonatal morbidity and mortality with arthrogryposis and mental retardation is common. We present a case where the family chose continuation of pregnancy with a known diagnosis of maternal and severe fetal myotonic dystrophy. A multidisciplinary team was used in the management of pregnancy and counseling the patient.

Adult↗