Background: Single-twin intrauterine death in the second and third trimesters poses a great concern and psychological stress to both the parents and the obstetrician. A multidisciplinary approach to conservative management is associated with improved perinatal outcome for the surviving twin. Case: We present a 30-year-old gravida 2 para 1 (1 alive). She had an emergency caesarean section during her first delivery. Having been referred from a military hospital, she presented at 22 weeks with single-twin intrauterine death. She was admitted and discharged after one week. Subsequently, she was managed conservatively and had weekly antenatal follow-up visits. She kept a daily fetal kick chart, had fortnightly ultrasound scans for fetal growth and wellbeing and weekly maternal clotting profile. At 37 weeks of gestation, she had a successful repeat caesarean delivery of a live, male neonate with a birth weight of 3.9kg and Apgar scores of 9 at one minute and 10 at five minutes. The remains of the dead co-twin (fetus papyraceus) were seen attached to the placenta. Follow-up by the neonatologist showed that his developmental milestones were normal and comparable to those of his singleton peers. Conclusion: The management of single-twin intrauterine death after the second trimester is psychologically tasking, requiring adequate counselling for the couple. The multidisciplinary approach, adopted in this study, improved perinatal outcome for the surviving co-twin after 15 weeks of conservative management. Prolonged paediatric follow-up of the survivor was imperative.
| Published in | Journal of Gynecology and Obstetrics (Volume 8, Issue 4) |
| DOI | 10.11648/j.jgo.20200804.18 |
| Page(s) | 113-116 |
| 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), 2020. Published by Science Publishing Group |
Single-twin Intrauterine Death, Conservative Management, Multidisciplinary Approach, Chorionicity, Maternal Coagulopathy, Fetus Papyraceus
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APA Style
Eka Po, Swende Tz, Ojabo Oa, Hembah-Hilekaan Sk, Ornguze Aa, et al. (2020). Conservative Management of Single-twin Death at 22 Weeks’ Gestation at A Tertiary Hospital in North-central Nigeria: A Case Report and Review of Literature. Journal of Gynecology and Obstetrics, 8(4), 113-116. https://doi.org/10.11648/j.jgo.20200804.18
ACS Style
Eka Po; Swende Tz; Ojabo Oa; Hembah-Hilekaan Sk; Ornguze Aa, et al. Conservative Management of Single-twin Death at 22 Weeks’ Gestation at A Tertiary Hospital in North-central Nigeria: A Case Report and Review of Literature. J. Gynecol. Obstet. 2020, 8(4), 113-116. doi: 10.11648/j.jgo.20200804.18
AMA Style
Eka Po, Swende Tz, Ojabo Oa, Hembah-Hilekaan Sk, Ornguze Aa, et al. Conservative Management of Single-twin Death at 22 Weeks’ Gestation at A Tertiary Hospital in North-central Nigeria: A Case Report and Review of Literature. J Gynecol Obstet. 2020;8(4):113-116. doi: 10.11648/j.jgo.20200804.18
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author = {Eka Po and Swende Tz and Ojabo Oa and Hembah-Hilekaan Sk and Ornguze Aa and Dabit Oj and Maanongun Mt and Okoh Ea and Adia Jt},
title = {Conservative Management of Single-twin Death at 22 Weeks’ Gestation at A Tertiary Hospital in North-central Nigeria: A Case Report and Review of Literature},
journal = {Journal of Gynecology and Obstetrics},
volume = {8},
number = {4},
pages = {113-116},
doi = {10.11648/j.jgo.20200804.18},
url = {https://doi.org/10.11648/j.jgo.20200804.18},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20200804.18},
abstract = {Background: Single-twin intrauterine death in the second and third trimesters poses a great concern and psychological stress to both the parents and the obstetrician. A multidisciplinary approach to conservative management is associated with improved perinatal outcome for the surviving twin. Case: We present a 30-year-old gravida 2 para 1 (1 alive). She had an emergency caesarean section during her first delivery. Having been referred from a military hospital, she presented at 22 weeks with single-twin intrauterine death. She was admitted and discharged after one week. Subsequently, she was managed conservatively and had weekly antenatal follow-up visits. She kept a daily fetal kick chart, had fortnightly ultrasound scans for fetal growth and wellbeing and weekly maternal clotting profile. At 37 weeks of gestation, she had a successful repeat caesarean delivery of a live, male neonate with a birth weight of 3.9kg and Apgar scores of 9 at one minute and 10 at five minutes. The remains of the dead co-twin (fetus papyraceus) were seen attached to the placenta. Follow-up by the neonatologist showed that his developmental milestones were normal and comparable to those of his singleton peers. Conclusion: The management of single-twin intrauterine death after the second trimester is psychologically tasking, requiring adequate counselling for the couple. The multidisciplinary approach, adopted in this study, improved perinatal outcome for the surviving co-twin after 15 weeks of conservative management. Prolonged paediatric follow-up of the survivor was imperative.},
year = {2020}
}
TY - JOUR T1 - Conservative Management of Single-twin Death at 22 Weeks’ Gestation at A Tertiary Hospital in North-central Nigeria: A Case Report and Review of Literature AU - Eka Po AU - Swende Tz AU - Ojabo Oa AU - Hembah-Hilekaan Sk AU - Ornguze Aa AU - Dabit Oj AU - Maanongun Mt AU - Okoh Ea AU - Adia Jt Y1 - 2020/08/20 PY - 2020 N1 - https://doi.org/10.11648/j.jgo.20200804.18 DO - 10.11648/j.jgo.20200804.18 T2 - Journal of Gynecology and Obstetrics JF - Journal of Gynecology and Obstetrics JO - Journal of Gynecology and Obstetrics SP - 113 EP - 116 PB - Science Publishing Group SN - 2376-7820 UR - https://doi.org/10.11648/j.jgo.20200804.18 AB - Background: Single-twin intrauterine death in the second and third trimesters poses a great concern and psychological stress to both the parents and the obstetrician. A multidisciplinary approach to conservative management is associated with improved perinatal outcome for the surviving twin. Case: We present a 30-year-old gravida 2 para 1 (1 alive). She had an emergency caesarean section during her first delivery. Having been referred from a military hospital, she presented at 22 weeks with single-twin intrauterine death. She was admitted and discharged after one week. Subsequently, she was managed conservatively and had weekly antenatal follow-up visits. She kept a daily fetal kick chart, had fortnightly ultrasound scans for fetal growth and wellbeing and weekly maternal clotting profile. At 37 weeks of gestation, she had a successful repeat caesarean delivery of a live, male neonate with a birth weight of 3.9kg and Apgar scores of 9 at one minute and 10 at five minutes. The remains of the dead co-twin (fetus papyraceus) were seen attached to the placenta. Follow-up by the neonatologist showed that his developmental milestones were normal and comparable to those of his singleton peers. Conclusion: The management of single-twin intrauterine death after the second trimester is psychologically tasking, requiring adequate counselling for the couple. The multidisciplinary approach, adopted in this study, improved perinatal outcome for the surviving co-twin after 15 weeks of conservative management. Prolonged paediatric follow-up of the survivor was imperative. VL - 8 IS - 4 ER -
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