MULTIPLE DELIVERY.
We need not repeat this subject here, but before examining the peculiarities presented by twin delivery, it will be well to point out the frequency of irregular presentations of the fcetus. Since the accommo dation of the foetus is rendered more difficult, such irregular presenta tions are self-evident. On referring to the statistics, we find that the children may present in the following modes: In twin pregnancy, parturition frequently occurs before term. Deptsul says, "twin delivery most commonly does not differ from single delivery, except in that the series of phenomena which precede and accompany the birth of the child in the latter, are reproduced twice in the former." Still we see, according to the above tabulation, that irregular presentations are frequently encountered and the intervention of the obstetrician is often required. Besides, even in cases where the presentation is regular, the course of labor is not rarely modified. In the first place, the uterine contractions may be feeble during the stage of dilatation, a fact attribu table to the excessive distension of the organ, and liable to pass away after the first bag of waters has ruptured, but which sometimes persists throughout the entire labor. Moreover, this excessive distension of the
uterus leads to inertia of the organ after delivery, and also predisposes to hemorrhage during and after parturition. In the majority of cases, after the birth of the first child, the uterus rests a little while, a quarter of an hour, a half-hour, or an hour at most; then labor is resumed and the second foetus expelled. But this is not always the case, and in certain in stances the interval which separates the birth of the two children may amount to several hours, several days, and sometimes even some months.
We have alluded to these facts in the article on " Super-fcetation." The course to be pursued in twin births, as well as the delivery and dystocia, will form the subject of separate chapters.