Unusual but Frequent Etiology of an Acute Perinatal Distress in Twin Pregnancies

Abstract

This paper aims at drawing the attention of obstetricians and pediatricians to a peculiar syndrome: a neonatal emergency without any preliminary signs of fetal distress. This emergency can be predicted before birth. The uterine content film obtained, when a twin pregnancy or an abnormal presentation is suspected, shows an extreme and permanent fetal malposition as early as the 6th month of gestation: the head is forcibly overextended, embedded in the spinal abnormal concavity. Its severity and duration entail a cervical elongation and a temporary atonia of inspiratory muscles. Respiratory autonomy is impossible at birth. A prolonged artificial ventilation should be organised and used immediately at birth to prevent death or any risk of transient cerebral anoxia. The acute neonatal neurological syndrome is only due to a purely peripheral motor and transitory impairment, and it will have no consequences.