Abstract
BackgroundDelayed interval intertwin delivery rates are expected to rise during the next years as potent and targeted tocolytic agents are employed and antenatal surveillance methods become more sophisticated and specific in predicting the critical delivery timepoint of optimal perinatal outcome.Case presentationWe present a case of delayed intertwin delivery after delivery of the first twin due to premature prelabor rupture of the membranes. Maternal serum White Blood Cells and C-Reactive Protein levels remained high until delivery of the second twin (34 days after the first was delivered), although maternal temperature remained constant. The mother underwent close antenatal surveillance and she was hospitalized. She had an uncomplicated delivery of the second twin at 29+ 2 weeks by cesarean section due to an abnormal Non-Stress Test.ConclusionWe strongly suggest future evaluation of maternal serum inflammatory markers among these rare cases as these could predict intraamniotic infection.
Highlights
Delayed interval intertwin delivery rates are expected to rise during the years as potent and targeted tocolytic agents are employed and antenatal surveillance methods become more sophisticated and specific in predicting the critical delivery timepoint of optimal perinatal outcome.Case presentation: We present a case of delayed intertwin delivery after delivery of the first twin due to premature prelabor rupture of the membranes
Twin pregnancy that is complicated by very preterm delivery of the first fetus is a challenge in modern obstetrics and, to date, evidence regarding the optimal time of delivery of the second twin is lacking
In the present study we report a case of Daskalakis et al BMC Pregnancy and Childbirth (2018) 18:206 delayed interval delivery of the second twin 34 days following delivery of the first
Summary
The rate of multiple pregnancies over the last three decades has increased dramatically due to extended implementation of Artificial Reproduction Techniques (ART) [1]. One week following admission (24+ 4) the patient experienced blood stained brownish vaginal secretions and the vaginal examination revealed a Bishop score of 8 She was transferred to the labor ward where she delivered a female that weighted 550 g. The patient remained in the high-risk pregnancy department and 5 days later she had a new blood and urine examination along with urine cultures that revealed elevated WBCs (13.900/μl), an a steep rise in CRP (31.78 mg/L) along with the presence of enterobacteriae spp. The surveillance protocol involved close laboratory assessment (WBC and CRP levels three times a week), ultrasonographic evaluation twice a week, vital signs clinical assessment (arterial pressure, heart rate, temperature) and electronic fetal monitoring (non stress test, NST) twice a day. It remained in the Neonatal Intensive Care Unit (NICU) for about 4 weeks
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