Delayed-Interval Delivery of an Extremely Preterm Twin after Abort of the First Twin and Emergency Total Cervical Occlusion at 19+1 Weeks of Gestation - a Case Report

• Published in: Zeitschrift fur Geburtshilfe und Neonatologie Vol. 227; no. 2; p. 147
• Main Authors: Kögel, Matthias, Werner, Matthias, Knuf, Markus, Hitschold, Thomas
• Format: Journal Article
• Language: German
• Published: Germany 01-04-2023
• Subjects: Adult; Cesarean Section; Female; Gestational Age; Humans; Infant, Extremely Premature; Infant, Newborn; Labor, Obstetric; Pregnancy; Pregnancy, Twin; Premature Birth
• ISSN: 1439-1651
• DOI: 10.1055/a-2010-8335

We report on the obstetric and neonatal course of a 34-year-old woman pregnant with twins, who presented at our clinic at 16+1 weeks of gestation with preterm premature rupture of membranes. We started intravenous antibiotic therapy with inpatient monitoring owing to the vitality and regular development of both twins, with anhydramnios in the leading twin. After a missed abortion of the leading twin at 19+1 weeks of gestation we decided on surgical intervention with assisted delivery of the aborted twin, leaving the placenta in situ with subsequent emergency total cervical occlusion. Afterwards, the single pregnancy could be continued until the 24th week of gestation. An urgent Caesarean section for early labor, premature rupture of membranes, and increasing signs of maternal infection was later performed. Overall, the postnatal course of the extremely preterm neonate was a success considering the gestational age. We conclude that the option of surgical interventions should be taken into account in similar cases in the future.