Lourdes Sala Climent, D. Borniquel Agulló, F. Xavier González Tallada, I. Llordella Sarmiento, Javier Medrano Juárez, M.J. Pelegay Escartín, N. Redondo López
{"title":"Beating the Record: 157 Days of Delayed Delivery of The Second Fetus in a Twin Pregnancy","authors":"Lourdes Sala Climent, D. Borniquel Agulló, F. Xavier González Tallada, I. Llordella Sarmiento, Javier Medrano Juárez, M.J. Pelegay Escartín, N. Redondo López","doi":"10.31487/j.crogr.2020.01.06","DOIUrl":null,"url":null,"abstract":"Case Report: We present the case of a diamniotic-dichorionic twin pregnancy of 14+4 weeks with obstetric\nhistory of cervical incompetence. The premature delivery of the first twin took place, with unfortunate\noutcome. The second twin was left in utero. The management, at first, included combination of expectant\nattitude with a close monitoring of maternal constants and analysis, and administration of antibiotics; in a\nsecond step, after discarding intraamniotic infection, a McDonald cerclage was performed with success. At\n37 weeks the cerclage was removed and after Oxytocin induction, a healthy baby was born.\nConclusion: Delayed delivery of the second fetus in a twin pregnancy is an effective management choice.\nThe use of cervical cerclage after the first delivery is associated with a longer inter-delivery interval. The\nbehaviour in these unusual cases should be assessed individually, due to the scarce literature on the matter\nand the lack of unanimous protocols. But, always considering the maternal and fetal status, trying to improve\nperinatal results with a strict maternal surveillance to discard the appearance of a possible intraamniotic\ninfection.","PeriodicalId":416165,"journal":{"name":"Case Reports in Obstetrics Gynecology and Reproductive","volume":"21 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2020-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Case Reports in Obstetrics Gynecology and Reproductive","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.31487/j.crogr.2020.01.06","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Case Report: We present the case of a diamniotic-dichorionic twin pregnancy of 14+4 weeks with obstetric
history of cervical incompetence. The premature delivery of the first twin took place, with unfortunate
outcome. The second twin was left in utero. The management, at first, included combination of expectant
attitude with a close monitoring of maternal constants and analysis, and administration of antibiotics; in a
second step, after discarding intraamniotic infection, a McDonald cerclage was performed with success. At
37 weeks the cerclage was removed and after Oxytocin induction, a healthy baby was born.
Conclusion: Delayed delivery of the second fetus in a twin pregnancy is an effective management choice.
The use of cervical cerclage after the first delivery is associated with a longer inter-delivery interval. The
behaviour in these unusual cases should be assessed individually, due to the scarce literature on the matter
and the lack of unanimous protocols. But, always considering the maternal and fetal status, trying to improve
perinatal results with a strict maternal surveillance to discard the appearance of a possible intraamniotic
infection.