The cesarean section procedure we have devised is not only safe, but has a lower risk of long- and short-term complications.

Due to the increased availability of infertility treatment, multiple pregnancies, with various resulting complications have become more common. A woman in the 19th week of a triplet pregnancy came to the hospital after the miscarriage of one of the fetuses at home. In keeping with our philosophy of minimal intervention in childbirth, we treated the woman conservatively. After confirming that the remaining two fetuses were in good condition, the woman was released home under ambulatory observation, with no antibiotics or tocolytic drugs. No further complications developed, and the woman gave birth in her 31st week to healthy twin girls 82 days later. The successful outcome of this case demonstrates that non-interventional, conservative methods could be a feasible alternative to invasive intervention. We hope that our case will encourage more physicians to try out and report noninterventional methods, so that enough information could be gathered to help make correct management decisions in the future.

Nonimmune hydrops fetalis (NIHF), occurring in 1 in 2,500–3,000 live births, has a reported mortality rate of 50–98%. A similar mortality rate for intrauterine death of fetuses with NIHF probably exists. Many fetal pathological entities have been implicated as causing the condition, but to date, treatment has only been found for cases of fetal tachycardia complicated with hydrops. During a routine ultrasonographic survey of a woman at 32 weeks of gestation, we detected a fetus with severe ascites. There was no apparent etiology, and although no tachycardia was evident, low dosage transplacental digoxin therapy was immediately initiated. The hydropic condition completely resolved within 17 days, and at 39 weeks of gestation, a perfectly normal baby was born after a spontaneous and uneventful labor. This is the first report of successful treatment of idiopathic NIHF with maternal digoxin.

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