the birth of the first baby, the lie, presentation, size and FHS of the second baby should be ascertained by abdominal examination or if required by real time ultrasound. A vaginal examination is also to be made not only to confirm the abdominal findings but to note the status of the membranes and to exclude cord prolapse, if any.
If the lie is transverse, it should be corrected by external version into a longitudinal lie preferably cephalic, if fails, podalic. If the external version fails, internal version under general anesthesia should be done forthwith. As the fetus is small there is no difficulty in performing internal version and it is the only accepted indication of internal version in present day obstetric practice.
If the membranes are ruptured, caesarean section is done immediately.
Thank you.