A case of locked twins managed under lumbar epidural analgesia.

A case of locked twins is described in which delivery of the aftercoming head of the first infant, which presented by the breech, was prevented by the presence below it of the head of the second infant, which presented by the vertex. Disimpaction under lumbar epidural analgesia was achieved, the head of the second infant being pushed up out of the pelvis. Both infants survived. This is thought to be the first case to be described in which disimpaction was achieved rapidly under lumbar epidural analgesia, thereby minimising the period of hypoxia to which the first infant was subjected.