Report of a New Case of Interlocking Heads in a Breech-Vertex Twin Delivery: A Conversation with My Residents

“Locked twins” is a rare event occurring in about 1 in every 1000 twin births. A 21-year-old primigravida with a 31-week twin pregnancy was admitted for delivery. The head of the first twin was locked to the chin of the second twin at the top of the symphysis pubis. Caesarean section was performed allowing the delivery of both dead twins. Twins gestations with first twin in the breech presentation raise index of suspicion of potential locked twin. However, management of such situation is controversial with most authors and colleges recommending caesarean section to avoid interlocking heads. We report another rare case of interlocking heads and bring up the topic about management of breech-first twin deliveries.