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Epidural Advantage Twin Pregnancy — FRCA Final MCQ

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ModerateObstetric AnaesthesiaEpidural Advantage Twin PregnancyFRCA Final

A 32-year-old woman (ASA I, 58 kg) at 37 weeks gestation with a twin pregnancy presents in spontaneous labour. Twin 1 is cephalic and twin 2 is breech. She requests epidural analgesia. Is there a specific advantage of epidural in twin deliveries?

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Correct answer: B — Epidural only benefits triplet or higher-order pregnancies

Epidural analgesia in twin pregnancies provides a specific advantage: it facilitates intra-uterine manipulation (internal podalic version and breech extraction) of the second twin if malpresentation occurs after delivery of twin 1. It also provides anaesthesia for emergency caesarean section if required for twin 2, avoiding the risks and delays of general anaesthesia. The epidural can be topped up rapidly for operative delivery. RCOG and OAA recommend early epidural placement in twin pregnancies.

Reference: RCOG – 2019 – Management of twin and triplet pregnancies; OAA/AAGBI – 2013 – Obstetric guidelines