Conservative treatment with successful outcome of a triplet pregnancy after the miscarriage of one fetus in the second trimester

Chavkin, Y.; Kupfersztain, C.; Guedj, P; Stark, Michael

doi:10.1016/0020-7292(94)90072-8

Cited by 9 publications

(5 citation statements)

References 8 publications

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“…The mean GA for the entire population at the birth of the first child was 26 weeks with a range of 19 5/7 -30 3/7 weeks (95% CI 24 1/7 -27 6/7 ). We did not observe any difference in the GA at the birth of the first child when comparing subgroup I (pat 4, 5, 7, 10, 13) and subgroup II (pat 1, 3,6,8,9), or considering the presenting symptoms. The GA of the patients in subgroup III (pat 2, 11,12,14,15) was high compared to the other 2 groups, since three patients exceeded 28 weeks at presentation.…”

Section: Symptoms and Gestational Age At The Birth Of The First Childcontrasting

confidence: 53%

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Delayed Interval Delivery in Multiple Pregnancies. Is Optimism Justified?

Doorn

Wezel‐Meijler

Geijn

et al. 2000

Obstetrical & Gynecological Survey

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Acta Obstet Gynecol Scand 1999; 78: 710-715. C Acta Obstet Gynecol Scand 1999 Objective. Evaluation of the success of delayed interval delivery in multiple pregnancies. Method. Retrospective analyses of all multiple pregnancies with the birth of one child at a gestational age of 16-31 weeks (nΩ80). Three groups were defined: group I, unsuccessful attempt to temporize delivery, group II, interval between the first child and the other child or children 3 hours or more, with delivery of the remaining children before 28 weeks and group III, prolongation of pregnancy beyond 28 weeks. Results. In 15 multiple pregnancies (ten sets of twins, five sets of triplets), the aim was to postpone the delivery of the second (and third) child. The mean gestational age at admittance was 25 weeks. Delay of the delivery of the second child was achieved in ten cases, five in group II and five in group III. In groups II and III, the mean interval of delivery was 12 days; the gestational age at the delivery of the remaining children in these ten patients was 27 5/7 weeks. No relation could be found between the reason for admittance and the interval in delivery between the first and the other children. The only severe maternal complication was blood loss exceeding 2 liters. In the neonatal outcome of first and second children (with a gestational age of 28 weeks or more) no striking differences were observed. Conclusion. Delayed delivery in multiple pregnancies after the birth of the first child is only successful in a minority of patients and should be considered prior to the birth of the first child.

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Section: Symptoms and Gestational Age At The Birth Of The First Childcontrasting

confidence: 53%

“…Table III shows the total follow up in months. (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) and unsuccessful data on delayed interval pregnancies (2)(3)(4)(16)(17)(18). From 1980 onwards, at least 89 cases have been published, including our ten group II and III cases.…”

Section: Neonatal Outcome (Subgroups II and Iii)mentioning

confidence: 99%

Delayed Interval Delivery in Multiple Pregnancies. Is Optimism Justified?

Doorn

Wezel‐Meijler

Geijn

et al. 2000

Obstetrical & Gynecological Survey

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“…Delivery was by cesarean section secondary to a footling breech presentation. 18 The other study dealt with a 17-week stillbirth and outpatient management was initiated until 25 weeks. At that time, contractions were appreciated and tocolysis along with steroids were begun.…”

Section: Discussionmentioning

confidence: 99%

Delayed Delivery of a Triplet Pregnancy Without Surgical Intervention: A Case Report

Ziegler¹,

Welgoss²

1996

Amer J Perinatol

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Multiple gestations have a significantly increased incidence of preterm labor and preterm rupture of membranes. This leads to an increase in neonatal morbidity and mortality due to prematurity. In this case, a 30-year-old woman achieved a triplet pregnancy by ovulation induction and intrauterine inseminations. Preterm premature rupture of membranes occurred at 21 6/7 weeks' gestation. At 24 weeks' gestation, preterm labor ensued and a vaginal delivery of the presenting triplet followed. Magnesium sulfate tocolysis was started after delivery. The patient was placed on bed rest, magnesium sulfate tocolysis, and weekly steroid injections. The second and third triplet delivered vaginally after a 46-day delay due to preterm labor. This is the first reported case of delayed delivery of the two remaining fetuses of a triplet pregnancy, after spontaneous preterm delivery of the presenting triplet, without surgical intervention. Although the first fetus expired 48 hours after delivery secondary to complications of prematurity, the other fetuses were subjected to tocolysis, bed rest, and steroids. This case illustrates that conservative management of a triplet pregnancy after preterm delivery of the presenting triplet may have a good outcome.

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“…The pati ent gave bi rth to a boy of 1100 g, (A pgar score of 7.7 and 8) and a gi rl of 1155 g, (A pgar score of 8. Resul ts and r evi ew of the l i ter atur e Del ayed del i very of one or several i nfants has been reported i n onl y 14 cases of tri pl et pregnancy [5][6][7][8][9][10][11][12][13][14][15][16][17] (Tabl e 1.) Pregnanci es w i th attempted del ayed del i very i n a di del phys uterus are rare but these cases are excl uded from thi s study as the pregnanci es devel op i n each horn.…”

Section: Case R Epor Tmentioning

confidence: 99%

“…19 Indeed, surgery may i ncrease the ri sk of i nfecti on such as chori oamni oti ti s, endometri ti s and w ound i nfecti on. 10,[12][13][14]16,19,20 On the other hand, cercl age performed i n opti mal asepti c conditi ons may avoi d contact w i th vagi nal bacteri a and, therefore, prevent rupture of the membranes. 6,7,9,17 M ost authors [6][7][8][9][10][11][12][15][16][17] suggest gi vi ng such pati ents tocol yti c treatment.…”

Section: Managementmentioning

confidence: 99%

Conservative management of triplet pregnancy after delivery of one foetus

et al. 2000

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Thi s paper i ntends to demonstr ate that the conser vati ve management of tr i pl et pr egnancy after del i ver y of one foetus i s a feasi bl e and r easonabl e appr oach. Thr ee cases of tr i pl et pr egnancy w i th successful conservative management after miscarriage of one foetus, are presented and compar ed w i th cases i n the l i ter atur e. The r oute of del i ver y, as w el l as the r ol e of tocol ysi s, cer cl age, pr ophyl acti c anti bi oti c ther apy and cor ti coster oi ds ar e di scussed. Gui del i nes for conser vati ve tr eatment ar e pr oposed. The del i ver i es of our thr ee pr egnanci es w er e del ayed by 63, 44 and 22 days r especti vel y. Foetal and neonatal evol uti on ar e nor mal i n fi ve of the r emai ni ng foetuses. Onl y one i ntr auter i ne death i s obser ved. No mater nal compl i cati ons w i th sequel ae ar e r epor ted. A fter abor ti on of the fi r st tr i pl et, contr acti ons often per si st and the bi r th of the tw o r emai ni ng foetuses may be unavoi dabl e. Never thel ess, i n our exper i ence, confi r med by some r epor ts i n the l i ter atur e, pr ol ongati on of the pr egnancy after expul si on of the fi r st foetus i s possi bl e. I t can be achi eved by cer vi cal cer cl age associ ated w i th tocol yti c and anti bi oti c ther apy. Thi s management i s not associ ated w i th si gni fi cantl y i ncr eased foetal -mater nal mor bi di ty. Twin Research (2000)

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Conservative treatment with successful outcome of a triplet pregnancy after the miscarriage of one fetus in the second trimester

Cited by 9 publications

References 8 publications

Delayed Interval Delivery in Multiple Pregnancies. Is Optimism Justified?

Delayed Interval Delivery in Multiple Pregnancies. Is Optimism Justified?

Delayed Delivery of a Triplet Pregnancy Without Surgical Intervention: A Case Report

Conservative management of triplet pregnancy after delivery of one foetus

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