Challenge in the Management of Twin Pregnancy with Anencephaly of One Fetus in a Low- Income Country: A Case Presentation

Romaric Joel Momo; Julius Dohbit Sama; Esther Meka; Mazou Ngou Temgoua; Pascal Foumane

doi:doi:10.11648/j.jgo.20190703.15

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Challenge in the Management of Twin Pregnancy with Anencephaly of One Fetus in a Low- Income Country: A Case Presentation

Romaric Joel Momo, Julius Dohbit Sama, Esther Meka, Mazou Ngou Temgoua, Pascal Foumane

Published in Journal of Gynecology and Obstetrics (Volume 7, Issue 3)

Received: 11 March 2019 Accepted: 23 April 2019 Published: 11 June 2019

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Abstract

Anencephaly of one twin is a frequent congenital abnormality in a twin pregnancy and it’s associated with a poor prognosis of this pregnancy. In developed countries, the goal standard management calls for an interventional fetal medicine either by injection of a cardiotoxic or by intervention on the umbilical cord. Another option is an expectative management with strict follow-up of pregnant women and delivery organized in a level 3 maternity. There is still a challenge in the management of such high risk pregnancy in low income countries. A 37 years-old female, G3P2002, referred from a clinic for the better management of a 28 weeks and 4 days twin pregnancy in labor. Obstetrical ultrasonography realized in the second trimester revealed dichorionic-diamniotic pregnancy and the presence of anencephaly with hydramnios of one twin. The expectative approach was adopted for the management of this high risk pregnancy, unfortunately the death of the fetus occurred despite all the care provided. This case brings to lamp light the difficulties encountered in providing standard obstetrical care for high risk pregnancies in resource limited settings.

Published in	Journal of Gynecology and Obstetrics (Volume 7, Issue 3)
DOI	10.11648/j.jgo.20190703.15
Page(s)	81-84
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Anencephaly, Twin Pregnancy, Low Income Country

References

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[2]	Mohammed. A, Naima. C, Loubna. B. Epidémiologie et facteurs de risque des anomalies de fermeture du tube neural: données marocaines. Panafrican Medical Journal. 2015; 22:43.
[3]	Annelies Lust, Luc De Catte, Liesbeth Lewi. Monochorionic and dichorionic twin pregnancies discordant for fetal anencephaly: a systematic review of prenatal management options. Prenat Diagn. 2008; 28: 275–279.
[4]	Amadou A, Sonhaye L, Douaguibe B. Anencéphalie sur grossesse gémellaire: une série de six cas; Medecine et Sante´ Tropicales. 2013; 23: 185-188.
[5]	Mohammed Amine Radouani1, Naima Chahid1, Loubna Benmiloud et alEpidémiologie et facteurs de risque des anomalies de fermeture du tube neural: données marocaines. Panafrican Medical Journal;2015; 22:43.
[6]	Lipitz S, Meizner I, Yagel S, Shapiro I, Achiron R, Schiff E. Expectant management of twin pregnancies discordant for anencephaly. ObstetGynecol. 1995; 86:6; 969–972.
[7]	Gaigi SS, Aida M, Sami J. Aspects foetopathologiques de 97 cas d’anencephalie: Etude du CMNR Tunis. Tunis Med. 2000; 78: 653-7.
[8]	Robyr R, Yamamoto M, Ville Y. Selective fetocide in complicated monochorionic twin pregnancies using ultrasoundguided bipolar coagulation. British journal of obsteric and gynaecology. 2005; 112: 1344–1348.
[9]	Delabaere A, Lemery D, Laurichesse H. J Gynecol Obstet Biol Reprod. 2010;39:S1-S342.
[10]	Eddleman KA, Stone JL, Lynch L, Berkowitz RL. Selective termination of anomalous fetuses in multifetal pregnancies: two hundred cases at a single center. Am J ObstetGynaecol. 2002; 187: 1168–1172.
[11]	De la Calle M, Arrieta S, Herro B. Dichorionic twin pregnancy discordant for anacephaly: two cases with different management; ClinExpObstet Gynecol. 2014; 41(2): 208-10.

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APA Style

Romaric Joel Momo, Julius Dohbit Sama, Esther Meka, Mazou Ngou Temgoua, Pascal Foumane. (2019). Challenge in the Management of Twin Pregnancy with Anencephaly of One Fetus in a Low- Income Country: A Case Presentation. Journal of Gynecology and Obstetrics, 7(3), 81-84. https://doi.org/10.11648/j.jgo.20190703.15

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ACS Style

Romaric Joel Momo; Julius Dohbit Sama; Esther Meka; Mazou Ngou Temgoua; Pascal Foumane. Challenge in the Management of Twin Pregnancy with Anencephaly of One Fetus in a Low- Income Country: A Case Presentation. J. Gynecol. Obstet. 2019, 7(3), 81-84. doi: 10.11648/j.jgo.20190703.15

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AMA Style

Romaric Joel Momo, Julius Dohbit Sama, Esther Meka, Mazou Ngou Temgoua, Pascal Foumane. Challenge in the Management of Twin Pregnancy with Anencephaly of One Fetus in a Low- Income Country: A Case Presentation. J Gynecol Obstet. 2019;7(3):81-84. doi: 10.11648/j.jgo.20190703.15

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@article{10.11648/j.jgo.20190703.15,
  author = {Romaric Joel Momo and Julius Dohbit Sama and Esther Meka and Mazou Ngou Temgoua and Pascal Foumane},
  title = {Challenge in the Management of Twin Pregnancy with Anencephaly of One Fetus in a Low- Income Country: A Case Presentation},
  journal = {Journal of Gynecology and Obstetrics},
  volume = {7},
  number = {3},
  pages = {81-84},
  doi = {10.11648/j.jgo.20190703.15},
  url = {https://doi.org/10.11648/j.jgo.20190703.15},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20190703.15},
  abstract = {Anencephaly of one twin is a frequent congenital abnormality in a twin pregnancy and it’s associated with a poor prognosis of this pregnancy. In developed countries, the goal standard management calls for an interventional fetal medicine either by injection of a cardiotoxic or by intervention on the umbilical cord. Another option is an expectative management with strict follow-up of pregnant women and delivery organized in a level 3 maternity. There is still a challenge in the management of such high risk pregnancy in low income countries. A 37 years-old female, G3P2002, referred from a clinic for the better management of a 28 weeks and 4 days twin pregnancy in labor. Obstetrical ultrasonography realized in the second trimester revealed dichorionic-diamniotic pregnancy and the presence of anencephaly with hydramnios of one twin. The expectative approach was adopted for the management of this high risk pregnancy, unfortunately the death of the fetus occurred despite all the care provided. This case brings to lamp light the difficulties encountered in providing standard obstetrical care for high risk pregnancies in resource limited settings.},
 year = {2019}
}

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TY  - JOUR
T1  - Challenge in the Management of Twin Pregnancy with Anencephaly of One Fetus in a Low- Income Country: A Case Presentation
AU  - Romaric Joel Momo
AU  - Julius Dohbit Sama
AU  - Esther Meka
AU  - Mazou Ngou Temgoua
AU  - Pascal Foumane
Y1  - 2019/06/11
PY  - 2019
N1  - https://doi.org/10.11648/j.jgo.20190703.15
DO  - 10.11648/j.jgo.20190703.15
T2  - Journal of Gynecology and Obstetrics
JF  - Journal of Gynecology and Obstetrics
JO  - Journal of Gynecology and Obstetrics
SP  - 81
EP  - 84
PB  - Science Publishing Group
SN  - 2376-7820
UR  - https://doi.org/10.11648/j.jgo.20190703.15
AB  - Anencephaly of one twin is a frequent congenital abnormality in a twin pregnancy and it’s associated with a poor prognosis of this pregnancy. In developed countries, the goal standard management calls for an interventional fetal medicine either by injection of a cardiotoxic or by intervention on the umbilical cord. Another option is an expectative management with strict follow-up of pregnant women and delivery organized in a level 3 maternity. There is still a challenge in the management of such high risk pregnancy in low income countries. A 37 years-old female, G3P2002, referred from a clinic for the better management of a 28 weeks and 4 days twin pregnancy in labor. Obstetrical ultrasonography realized in the second trimester revealed dichorionic-diamniotic pregnancy and the presence of anencephaly with hydramnios of one twin. The expectative approach was adopted for the management of this high risk pregnancy, unfortunately the death of the fetus occurred despite all the care provided. This case brings to lamp light the difficulties encountered in providing standard obstetrical care for high risk pregnancies in resource limited settings.
VL  - 7
IS  - 3
ER  -

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Author Information

Romaric Joel Momo

Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaoundé, Cameroon
Julius Dohbit Sama

Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaoundé, Cameroon
Esther Meka

Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaoundé, Cameroon
Mazou Ngou Temgoua

Public Health Department, Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaoundé, Cameroon
Pascal Foumane

Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaoundé, Cameroon

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APA Style

Romaric Joel Momo, Julius Dohbit Sama, Esther Meka, Mazou Ngou Temgoua, Pascal Foumane. (2019). Challenge in the Management of Twin Pregnancy with Anencephaly of One Fetus in a Low- Income Country: A Case Presentation. Journal of Gynecology and Obstetrics, 7(3), 81-84. https://doi.org/10.11648/j.jgo.20190703.15

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ACS Style

Romaric Joel Momo; Julius Dohbit Sama; Esther Meka; Mazou Ngou Temgoua; Pascal Foumane. Challenge in the Management of Twin Pregnancy with Anencephaly of One Fetus in a Low- Income Country: A Case Presentation. J. Gynecol. Obstet. 2019, 7(3), 81-84. doi: 10.11648/j.jgo.20190703.15

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AMA Style

Romaric Joel Momo, Julius Dohbit Sama, Esther Meka, Mazou Ngou Temgoua, Pascal Foumane. Challenge in the Management of Twin Pregnancy with Anencephaly of One Fetus in a Low- Income Country: A Case Presentation. J Gynecol Obstet. 2019;7(3):81-84. doi: 10.11648/j.jgo.20190703.15

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@article{10.11648/j.jgo.20190703.15,
  author = {Romaric Joel Momo and Julius Dohbit Sama and Esther Meka and Mazou Ngou Temgoua and Pascal Foumane},
  title = {Challenge in the Management of Twin Pregnancy with Anencephaly of One Fetus in a Low- Income Country: A Case Presentation},
  journal = {Journal of Gynecology and Obstetrics},
  volume = {7},
  number = {3},
  pages = {81-84},
  doi = {10.11648/j.jgo.20190703.15},
  url = {https://doi.org/10.11648/j.jgo.20190703.15},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20190703.15},
  abstract = {Anencephaly of one twin is a frequent congenital abnormality in a twin pregnancy and it’s associated with a poor prognosis of this pregnancy. In developed countries, the goal standard management calls for an interventional fetal medicine either by injection of a cardiotoxic or by intervention on the umbilical cord. Another option is an expectative management with strict follow-up of pregnant women and delivery organized in a level 3 maternity. There is still a challenge in the management of such high risk pregnancy in low income countries. A 37 years-old female, G3P2002, referred from a clinic for the better management of a 28 weeks and 4 days twin pregnancy in labor. Obstetrical ultrasonography realized in the second trimester revealed dichorionic-diamniotic pregnancy and the presence of anencephaly with hydramnios of one twin. The expectative approach was adopted for the management of this high risk pregnancy, unfortunately the death of the fetus occurred despite all the care provided. This case brings to lamp light the difficulties encountered in providing standard obstetrical care for high risk pregnancies in resource limited settings.},
 year = {2019}
}

Copy | Download

TY  - JOUR
T1  - Challenge in the Management of Twin Pregnancy with Anencephaly of One Fetus in a Low- Income Country: A Case Presentation
AU  - Romaric Joel Momo
AU  - Julius Dohbit Sama
AU  - Esther Meka
AU  - Mazou Ngou Temgoua
AU  - Pascal Foumane
Y1  - 2019/06/11
PY  - 2019
N1  - https://doi.org/10.11648/j.jgo.20190703.15
DO  - 10.11648/j.jgo.20190703.15
T2  - Journal of Gynecology and Obstetrics
JF  - Journal of Gynecology and Obstetrics
JO  - Journal of Gynecology and Obstetrics
SP  - 81
EP  - 84
PB  - Science Publishing Group
SN  - 2376-7820
UR  - https://doi.org/10.11648/j.jgo.20190703.15
AB  - Anencephaly of one twin is a frequent congenital abnormality in a twin pregnancy and it’s associated with a poor prognosis of this pregnancy. In developed countries, the goal standard management calls for an interventional fetal medicine either by injection of a cardiotoxic or by intervention on the umbilical cord. Another option is an expectative management with strict follow-up of pregnant women and delivery organized in a level 3 maternity. There is still a challenge in the management of such high risk pregnancy in low income countries. A 37 years-old female, G3P2002, referred from a clinic for the better management of a 28 weeks and 4 days twin pregnancy in labor. Obstetrical ultrasonography realized in the second trimester revealed dichorionic-diamniotic pregnancy and the presence of anencephaly with hydramnios of one twin. The expectative approach was adopted for the management of this high risk pregnancy, unfortunately the death of the fetus occurred despite all the care provided. This case brings to lamp light the difficulties encountered in providing standard obstetrical care for high risk pregnancies in resource limited settings.
VL  - 7
IS  - 3
ER  -

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