Abstract
An en caul delivery is a very rare obstetric condition that offers protective benefits against fetal mechanical trauma during preterm or complicated births. This case presents an extremely rare occurrence of a term monochorionic diamniotic twin delivery via lower-segment cesarean section in a 21-year-old primigravida with gestational diabetes mellitus. The first twin was delivered following intentional artificial rupture of membranes, whereas the second twin was successfully extracted en caul within an intact amniotic sac. Both live female neonates showed favorable APGAR scores and required no neonatal intensive care unit admission. Both the mother and the neonates were discharged without any complications on the fourth postoperative day. This case emphasized that controlled en caul extraction of a co-twin may be safely performed at term, optimizing fetal outcomes without increasing any maternal morbidity.
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Copyright (c) 2026 Santosh Kumar Chaudhary, Anjana Kafle, Navita Kandel Bharati, Pawan Tiwari, Preeti Jaiswal