Survival of both twins in a pregnancy complicated by pre-viable cord prolapse at 21 weeks of gestation

Abdullah, Aszrin; Alsarraj, Ghazi; Brown, Richard N

doi:10.1515/crpm-2019-0060

Cited by 2 publications

(2 citation statements)

References 6 publications

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“…In a previous report of conservative management, PPROM and cord prolapse of the first twin occurred at 24 weeks, while delivery of the second twin occurred at 28 weeks [9]. In another case, both fetuses were delivered at the same time at 28 weeks of gestation by extending the pregnancy period from 21 weeks after the first fetal cord prolapse [5].…”

Section: Discussionmentioning

confidence: 92%

“…Although there have been several case reports of extending pregnancy via conservative management of very early PPROM in twin pregnancy [4], there have been very few reports of healthy delivery of the remaining fetus by extension of the gestational period after cord prolapse of the affected fetus very early during the second trimester. There are two management approaches to this clinical condition: either the pregnancy period is extended through conservative management for delivery at the same time, or the pregnancy of the remaining fetus is extended after delivery of the affected fetus [5,6]. Unfortunately, there is no validated protocol to prolong the gestational period or reduce the morbidity and mortality of the remaining fetus.…”

Section: Introductionmentioning

confidence: 99%

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Successful delayed delivery of the second twin by evacuating the cord prolapsed first fetus and emergent cerclage: a report of 2 cases

Park

Jung

Park

et al. 2022

BMC Pregnancy Childbirth

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Background In twin pregnancies, the cord prolapse of either fetus during the pre-viable period leads to fetal death but can also cause an intrauterine infection, leading to death or prematu-re birth of the remaining fetus. However, there are no validated protocols to prolong the gestational period or decrease the morbidity and mortality of the remaining fetus. Case presentation The present cases were PPROM and cord prolapse very early during the second trimester (around 17 weeks in the first case and 19 weeks in the second case). The first fetus was evacuated, and cervical cerclage was performed at 23 and 20 weeks in the two cases, respectively. After maintaining the pregnancy, the second baby was born around 27 and 39 weeks in the first and second cases, respectively. The delivery interval between the first and second fetuses was 46 days in the first case and 126 days in the second case. Conclusion If cord prolapse is identified at a pre-viable time in twin fetuses, evacuation and cerclage should be performed as soon as possible after the cord prolapse to reduce intrauterine infection and increase the survival chances of the remaining fetus.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Successful delayed delivery of the second twin by evacuating the cord prolapsed first fetus and emergent cerclage: a report of 2 cases

Park

Jung

Park

et al. 2022

BMC Pregnancy Childbirth

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Emergency cervical cerclage in delayed-interval delivery of twin pregnancies: a scoping review

Cui,

Li,

Yin

2024

BMC Pregnancy Childbirth

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Background The protocol for delayed-interval delivery of the second twin in twin pregnancies has not been standardized. Cervical cerclage is often performed, but its use is debated. To conduct a scoping review on cervical cerclage for prolonging the intertwin delivery interval and improving second twin survival and maternal outcomes after preterm delivery or spontaneous abortion of the first twin in twin pregnancies. Methods Seven Chinese and English language databases were searched from inception to March 1, 2023, including PubMed, The Cochrane Library, Web of Science, CNKI, Wanfang Data, VIP Chinese Science Journal Database, and Sinomed. Relevant observational studies that assessed the effectiveness of the use of cervical cerclage in delayed-interval delivery of twins were screened and selected, and raw data were extracted, and descriptive statistics and chi-square analysis were performed. Results A total of 102 articles were retrieved. After screening and exclusion of duplicate and irrelevant articles, 22 articles meeting the inclusion criteria were obtained. Studies in which cerclage was performed reported longer intertwin delivery intervals than those that did not perform cerclage, and the difference was statistically significant. The cerclage group also tended to have lower rates of chorioamnionitis and maternal complications, but the difference between the two groups was not statistically significant. Conclusion After excluding patients with contraindications, emergency cervical cerclage can be considered in cases of spontaneous abortion of the first twin in twin pregnancies to prolong the gestation and improve the prognosis of the remaining fetus until it becomes viable and increases its birth weight.

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Survival of both twins in a pregnancy complicated by pre-viable cord prolapse at 21 weeks of gestation

Cited by 2 publications

References 6 publications

Successful delayed delivery of the second twin by evacuating the cord prolapsed first fetus and emergent cerclage: a report of 2 cases

Successful delayed delivery of the second twin by evacuating the cord prolapsed first fetus and emergent cerclage: a report of 2 cases

Emergency cervical cerclage in delayed-interval delivery of twin pregnancies: a scoping review

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