(2) Start intravenous infusion with at least an 18-gauge as soon as the
patient presents to labor and delivery.
(3) Type and cross-match the patient for blood (at least 2 units) on
admission for possible administration or as stated in the unit SOP.
Notify appropriate personnel to be present for actual delivery.
(a) An anesthesiologist or anesthetist should be notified in case an
emergency cesarean becomes necessary. Anesthesia may be required for the delivery
of the subsequent fetuses.
(b) A physician and a nurse team should be notified for each fetus.
The nurse should be skilled in resuscitative measures. The physician should be a
(5) Have enough equipment available to accommodate the number of
fetuses to be delivered.
Identify and care for each fetus immediately at delivery.
(a) The first fetus born is A or twin I.
(b) The second fetus is B or twin II. and so on.
Tag the infant prior to leaving the delivery room. Do not depend
Keep the mother informed of each infant's status.
(a) Identify the sex of the infant.
(b) Allow the mother to see the infant prior to being transferred from
the delivery room if at all possible.
(8) Administer Pitocin as soon as all placentas are delivered and upon
physician's order. Massage the fundus to stimulate contractility. Excessive blood loss
is common with multiple pregnancy during the third stage of labor.
FACTS RELATED TO CESAREAN SECTION DELIVERY
a. Definition. Cesarean section refers to a surgical incision made into the
abdomen and uterus to deliver the fetus (see figure 5-1).