{"title":"Optimal management strategies for promoting gestational extension in dichorionic diamniotic twin pregnancies.","authors":"Caixia Chen, Changyou Fan, Bufei Wang, Ping Zhu","doi":"10.3389/fphys.2024.1489780","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Preterm birth is a significant concern in multiple pregnancies, warranting effective strategies to improve outcomes. Delaying delivery of the second fetus is crucial for reducing perinatal mortality rates.</p><p><strong>Case presentation: </strong>In a dichorionic diamniotic twin pregnancy, one fetus experienced premature rupture of membranes (PROM) at 16+6 weeks gestation. Proactive fetal reduction through potassium chloride injection and emergency cervical cerclage at 19+1 week successfully extended the pregnancy to 39+5 weeks, resulting in a notable 160-day prolongation. Postoperative management encompassed comprehensive tocolytic therapy.</p><p><strong>Conclusion: </strong>The combined approach of proactive fetal reduction and emergency cervical cerclage proved successful in managing PROM in dichorionic diamniotic twin pregnancies. This innovative strategy offers a promising clinical solution for optimizing outcomes and prolonging gestation in high-risk multiple pregnancies, underscoring the importance of tailored interventions in complex obstetric scenarios.</p>","PeriodicalId":12477,"journal":{"name":"Frontiers in Physiology","volume":"15 ","pages":"1489780"},"PeriodicalIF":3.2000,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11628491/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Physiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fphys.2024.1489780","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PHYSIOLOGY","Score":null,"Total":0}
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Abstract
Background: Preterm birth is a significant concern in multiple pregnancies, warranting effective strategies to improve outcomes. Delaying delivery of the second fetus is crucial for reducing perinatal mortality rates.
Case presentation: In a dichorionic diamniotic twin pregnancy, one fetus experienced premature rupture of membranes (PROM) at 16+6 weeks gestation. Proactive fetal reduction through potassium chloride injection and emergency cervical cerclage at 19+1 week successfully extended the pregnancy to 39+5 weeks, resulting in a notable 160-day prolongation. Postoperative management encompassed comprehensive tocolytic therapy.
Conclusion: The combined approach of proactive fetal reduction and emergency cervical cerclage proved successful in managing PROM in dichorionic diamniotic twin pregnancies. This innovative strategy offers a promising clinical solution for optimizing outcomes and prolonging gestation in high-risk multiple pregnancies, underscoring the importance of tailored interventions in complex obstetric scenarios.
期刊介绍：
Frontiers in Physiology is a leading journal in its field, publishing rigorously peer-reviewed research on the physiology of living systems, from the subcellular and molecular domains to the intact organism, and its interaction with the environment. Field Chief Editor George E. Billman at the Ohio State University Columbus is supported by an outstanding Editorial Board of international researchers. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
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