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Non Immune Fetal Hydrops (FH) caused by Parvovirus B19 in one dichorionic-diamnotic (DCDA) twin has been reported but remains extremely rare.1 2 We describe FH affecting one twin in a DCDA pregnancy. The mother was 26 years old in her 4th pregnancy. Her blood group was A Rhesus positive. Ultrasound scan at 20+5 gestation confirmed FH in one twin with no structural abnormality. Middle cerebral artery peak systolic velocity (MCA PSV) was elevated at 43.0cm/s (>1.55MOM).3 Ultrasound assessment of the second twin confirmed normal anatomy with no evidence of FH. Findings suggested FH secondary to anaemia in only one twin. Assessment followed in the tertiary centre with subsequent amniocentesis and intrauterine blood transfusion at 21+0. Pre-transfusion haemoglobin (Hb) was 4.6g/dl. 15ml of 75% donor blood was transfused with post-transfusion Hb of 11.4g/dl. Maternal serology was positive for Parvovirus B19 specific immunoglobulin (IgM). Ultrasound confirmed resolution of FH and normal MCA PSV by 24+4. Growth of the affected twin remained below the 10th centile while the second twin's growth was appropriate for gestation. Caesarean section was performed in early labour at maternal request at 35+4, birth weights were 1790g and 2460g. Parvovirus B19 is a major cause of non-immune FH and responsible for 15-20% of cases within the United Kingdom.4 Trans-placental passage rates approach 25%4 but the incidence of FH is about 4%.5 Maternal viral load, gestation and immune responses influence fetal infection rates however the exact mechanism for discordant FH in DCDA pregnancies remains unclear.

Background/Introduction/AimsIn current obstetric practice there is limited evidence to underpin the wide variation of suture material used for skin closure at caesarean section. A pilot study examined the rates of wound healing between two of the most common locally used suture materials (beaded prolene and dexon). Methodology Of the patients assessed for eligibility (n=140) between November 2010 – April 2011, 47 women undergoing elective CS were randomised into two groups of 23. (19 received dexon, 22 received beaded prolene and the remainder received alternative suture material based on clinical need). Data from one participant was lost. A descriptive survey in the form of two questionnaires were completed by midwives and women up to thirty days post CS to compare the different rates of wound healing for each suture material and four secondary outcomes (BMI, infection, pain and cosmetic appearance of the wound). Results Rates of wound healing were compared using the REEDA scale. The sample demonstrated low homogenous values and statistical analysis of wound assessment found the null hypothesis was retained (p=0.213). Bruising was a common element with 34% (n=20) scoring 1-3 at the second assessment. Use of visual analogue scales to assess pain demonstrated a mean of 4.5 with a SD of 2.2 and a positive skew resulting from one score of 10. Conclusions/Recommendations Cost analysis demonstrated beaded prolene is a third more expensive than dexon with no significant difference in clinical outcome. Despite the results showing no clinical significance for each of the proposed outcomes the study has highlighted pain assessment and management in the first 24 hours as an area for development.