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Management of third stage, + Routine administration of 0.2mg methergin “Vv with, delivery of anterior shoulder., , + Deliver placenta by CCT, , + Continue oxytocin drip for at least one hour, following, delivery of second baby., , + The patient is to be carefully watched for about 2 hours, after delivery., , Indications of caesarean section, , Obstetric causes:, — Placenta previa, — Severe preeclampsia, — Previous caesarean section, — Cord prolapse of the first baby, — Abnormal uterine contractions, — Contracted pelvis, , , , + For twins: Both fetuses or even first fetus with noncephalic presentation,, , + Twins with complications: \UGR, conjoint twins;, Monoamniotic twins, monochorionic twins with TTS, , Page 47, , Management of difficult cases of, twins, , , , Interlocking, + Commonest: .*“, with forecomin, , * -f first baby getting locked, by., + Vaginal manip | ‘hins of the fetuses, , ), pushing up decapitated, id baby and lastly, delivery, , + Decapitation «, head, followec, of decapitated, , , , + Occasionally, two heads of both vertex get locked at the, pelvic brim preventing engagement of either of the head., , * Disengagement of the higher head: Under general