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Management of difficult cases of, twins contd.., , , , Conjoined twins, + Extremely rare., , + Often diagnosed during delivery, , + Presence of a bridge of tissue between the fetuses on, vaginal examination confirms the diagnosis., , + Antenatal diagnosis is important., , + Benefits are: reduces maternal trauma and, morbidity, improves fetal survival, helps to plan method, of delivery, allows time to organize pediatric surgical, team., , Page 49, , Postnatal period, , Care of the babies, , + Immediate care, , + Maintenance of body temperature,, + Use of overhead heaters,, , + Parents given the opportunity to check the identity tag, and cuddle them., , , , Breastfeeding, , + Provide knowledge to mother regarding different, positions for breastfeeding, along with advantages,, attachment, positioning timing., , Postnatal period contd.., , Nutrition ,, , + Expressed breast milk is best (for small babies), they may’need to, be fed intravenously or by nasogastric tube or cup-fed, depending, on their size and general condition., , * Careful monitoring of weight gain, regular capillary blood glucose, estimations, , + Reassure her that lactation responds to the demands made by, babies sucking at the breast., , + At feeding times, mother must be provided support and advised on, positioning and fixing babies.