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2. Breech: Breech extraction., , 3. Lie transverse: Correct by external version or internal, version to cephalic or podalic., , Page 43, , Management during labour contd., , , , Indication of urgent delivery of second babys, — Severe vaginal bleeding,, — Cord prolapse, — Inadvertent use of IV ergometrine with the delivery of, anterior shoulder of the first baby,, — First baby delivered under general anesthesia,, , — Appearance of fetal distress., , Management during labour contd., , , , Delay in the birth of second twin, , + Birth of second twin should be completed within 45, minute of the first twin being born but with close, monitoring can be extended if there are no signs of fetal, compromise., , + The risk of delays:, — intrauterine hypoxia,, — birth asphyxia,, , — sepsis, , Management during labour contd..., , , , Management of third stage 1, + Routine administration of 0.2mg methergin “IV with, delivery of anterior shoulder.