Treatment of twin complicated foetal malpresentation

Author

Reuven Barak

Introduction

A 35 old multipara contacted me asking if i could help her with the malpresentation of the twins she was carrying in her belly.

Sha was in the 36th week of her pregnancy, carrying twins in separate amniotic sacks.Twin no. 1, the female, was well sited in breech position. Twin no. 2, the male was high in head position. The situation is known as "locked twins" making vaginal delivery impossible.

As she wanted to have the babies at home, and avoid the almost inevitable Caesarean Section she asked me to help her.

Treatment

At the beginning of her 37th week of pregnancy we started with Moxibustion of BL 67 Zhiyin, bilateral, once a day for 10 minutes on each side.

The Moxibustion was performed by the Ladies' husband at evenings. After a week she reported, that according to the UltraSound examination, twin no. 1 hadn't moved, but Twin No. 2 had changed to Transverse presentation. The Ladies' Doctor was satisfied, but as Twin No. 2 was high, he was afraid it might turn back to head presentation. I summoned the lady to my clinic and did once Acupuncture on BL 67 Zhiyin, instructing her to continue with the home Moxibustion and asked her to report daily. After 4 more days of home moxibustion Twin No. 2 turned to Breech presentation, while twin No. 1 didn't move. I asked the lady to stop all treatments, 2 days later, at 04:00 she had a rupture of the membranes and started Labour at her home, after twin No. 1 was delivered in complete breech presentation, twin no 2 CHANGED FROM BREECH TO HEAD in utero (as reported by the doctor and the midwife) and delivered normally.

We couldn't assess, while performing moxibustion and acupuncture, whether there was a difference in the effect of the right-leg BL 67 or the left one. According to the ladies' report, usually it was the male (no. 2) baby that moved, no matter which side was treated.

Reuven Barak, MD
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