Many aspects of the obstetric management of a twin pregnancy are different than for a singleton pregnancy.
Angle btwn femoral mechanical axis (drawn from center of femoral head to intercondylar notch) and tibial mechanical axis (drawn from center of tibial plateau to center of tibial plafond) is xdeg varus/valgus on the right and ydeg varus/valgus on the left.
(Note: angles reported as deviation from 180; neg are varus=apex lateral; and pos are valgus=apex medial) 6 non-rib bearing lumbar-type vertebral bodies [with the most inferior vertebral body labeled as L6 for purposes of this dictation] [with most superior vertebral body presumed to represent T12 with hypoplastic ribs].
The risk of neurologic abnormality is greater in mochorionic twins (18-26%) than dichorionic twins (1-2 %).*** Immediate delivery after the demise of a twin in the late second or early third trimester has not been shown to be of benefit for the other twin. Please use our online form to send us your twin pregnancy question, and one of our maternal-fetal medicine specialists will respond.
The surveillance and delivery recommendations should be individualized, but generally, in the absence of any other complications, delivery before 34 weeks is not recommended. Prognosis for the co-twin following single-twin death: a systematic review. Please note that your question will be emailed and responded through a private and secure system.
Stylet was replaced and the spinal needle was removed. Patient was placed on prone position on fluoroscopy table. 1% Lidocaine was used for Local anesthesia.[ L2-3 or L3-4] interspace was localized.
Patient was placed in left lateral decubitus position midway thru CSF collection to help continue CSF flow. Under fluoro guidance, a G spinal needle was advanced along the right paramidline interlaminar space into the thecal space with a single pass.Overall appearance is unchanged from prior studies with no focal lytic lesion or absence of sclerotic rim at bone-cement interface to suggest recurrence.Modified enteroclysis was performed using thin barium and air (for double contrast imaging of small bowel) via an 8fr feeding tube placed under fluoroscopic guidance with tip [near/distal to] ligament of Trietz. Patient is s/p open reduction internal fixation (ORIF) with [fixation plate and screws or fixation hardware] providing [appropriate/near anatomic] alignment. 100% displacement/translation of distal fx fragment] [mm foreshortening or bayonette apposition/overriding] [distracted] [with interposed butterfly fragment] [fracture-dislocation] [articular step-off or incongruity].Fracture lucency remains partially visible.[Bimalleolar fx] [Trimalleolar fx] [Pilon fx with comminuted distal tibia] [Tillaux fracture involving anterolateral tibia] [Triplane fx in skeletally-immature patient] [Recommend dedicated tib-fib Xray to exclude proximal fibular fracture or Maisonneuve’s] FINDINGS: [Single] K-wire traverses [x] ray extending percutaneously from distal tuft across IP/MTP jts with tip at  providing good anatomic alignment s/p [hammer toe repair] with [resection arthroplasty at x joint].