Femoral shaft in twin pregnancy of new-borns by caesarean section is rare and not a common occurrence. Literature has highlighted long bone fractures to be very common in virginal delivery compared to caesarean section. Foetal injuries complicated 1.1%. In a multicentre randomised study by Hannah et al. showed that the incidence of fracture of long bones in caesarean section is 0.1% and 0.5% in vaginal delivery. Hence caesarean section reduces the incidence of femur fractures, however some difficult extractions and manoeuvres employed during caesarean section can lead to femur fractures in neonates. Our case report is a twin pregnancy of 1st twin (girl) in transverse lie and the other 2nd twin (boy) in breech with cord around the neck which was taken up for emergency C-section in view of foetal growth retardation grade 3 (FGR) of 2nd twin with reversed end diastolic flow (EDF) in the 1st twin.
Chetan John Rasquinha , Ghanaprakash Pallaniappan, Sutharsen NR, Major K Kamalanathan and Hubert Praveen Abner