EC Gynaecology

Introduction: Twin pregnancy is associated with increased obstetric risks, including preterm labor, fetal growth restriction, and higher operative delivery rates. Among these, locked twins represent a rare but life-threatening complication, occurring in approximately 1 in 1,000 twin pregnancies. This condition arises when the heads of the twin interlock, often in breech and cephalic presentations, causing mechanical labor obstruction. We present a case of chin-to-chair locked twins that occurred at the gestational age of 33 weeks plus 5 days.

Case Summary: A 20-year-old primigravida mother presented with a history of ten hours of leakage of fluid per vagina and nine hours of pushing down pain at the gestational age of 33 weeks plus 5 days. With a diagnosis of the chin–to–chin interlocked twin pregnancy and intrauterine fetal death, craniotomy was done for the second twin delivery to enable smooth vaginal delivery without the need for episiotomy or vaginal tear repair.

Conclusion: Management of locked twins with IUFD requires decisive actions to protect maternal health, and destructive procedures like craniotomy remain essential interventions in such cases.

 Keywords: Locked Twins; Intrauterine Fetal Death; Craniotomy

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