Successful obstetrical management of 110-day intertwin delivery interval without cerclage: Counseling and conservative management approach to extreme asynchronous twin birth

Labib M. Ghulmiyyah, Salim A. Wehbe, Seth A. Schwartz, Eric Scott Sills

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: This report describes a patient counseling approach and non-surgical management of a dichorionic-diamniotic twin pregnancy where delivery of the second twin followed the delivery of the first by 110 days. Case presentation: An early transvaginal sonogram at 19 1/2 weeks suggested cervical dilation with protruding amniotic membranes. Tocolytic and antibiotic therapy was initiated; no cerclage was placed. Spontaneous rupture of membranes and cord prolapse occurred 48 h later, resulting in delivery of a stillborn female infant. Conservative management was offered after counseling for possible risks associated with maternal sepsis, need for extended hospitalization, potential for hysterectomy and death. The cervix appeared closed after delivery and the umbilical cord was ligated, with subsequent spontaneous cord retraction in utero. Reassuring fetal status was observed for twin B without evidence of contractions or chorioamnionitis. A viable male infant (2894 g) was delivered vaginally at 35 1/2 weeks. Conclusions: This report outlines a counseling approach useful for patients with premature delivery of one twin, and presents application of conservative obstetrical management principles for the aftercoming twin even when delivery interval is extreme.

Original languageEnglish (US)
Article number23
JournalBMC Pregnancy and Childbirth
Volume4
DOIs
StatePublished - Dec 6 2004
Externally publishedYes

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Counseling
Parturition
Tocolysis
Chorioamnionitis
Twin Pregnancy
Spontaneous Rupture
Amnion
Umbilical Cord
Prolapse
Hysterectomy
Cervix Uteri
Dilatation
Sepsis
Hospitalization
Mothers
Anti-Bacterial Agents
Membranes
Conservative Treatment

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Successful obstetrical management of 110-day intertwin delivery interval without cerclage : Counseling and conservative management approach to extreme asynchronous twin birth. / Ghulmiyyah, Labib M.; Wehbe, Salim A.; Schwartz, Seth A.; Sills, Eric Scott.

In: BMC Pregnancy and Childbirth, Vol. 4, 23, 06.12.2004.

Research output: Contribution to journalArticle

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