Successful twin pregnancy in a patient with complete uterine septum corrected during cesarean section

Abstract Septum resection using hysterescopy is safe, rapid and efective, but some late complication of it may be seen as uterine rupture or dehiscence of uterine wall during pregnancy due to myometrial damage. We present a case of recurrent large uterine fundal dehiscence conscecutive to cesarean section in a patient who had previously undergone a uterine septum resection. The patient was a 35-year-old who presented at 39 weeks of gestation (Gravida 2, Parity 1) and was admitted for an elective cesarean section. Her reproductive history included a septum resection which resulted in uterine perforation, and one previous cesarean section in which a large fundal defect was found and repaired. Then the examination had shown an aproximately 5 cm large uterine fundus defect including all three layers of uterus which had been repaired. Perforation or excessively deep incision of uterine fundus during hysteroscopic metroplasty may cause chronic weakness of the uterine wall especially at fundal localization. Our case was an incidental uterine wall dehiscence during cesarean section. Patients with an uterine septum resection history should be followed up carefully for uterine rupture during pregnancy.

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Efficacy of carbetocin for preventing postpartum bleeding after cesarean section in twin pregnancy

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.1080/14767058.2018.1489532 ◽

2018 ◽

Vol 33 (2) ◽

pp. 267-271

Author(s):

Laura Sotillo ◽

Maria De la Calle ◽

Fernando Magdaleno ◽

Jose Luis Bartha

Keyword(s):

Cesarean Section ◽

Twin Pregnancy ◽

Postpartum Bleeding

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Buttock necrosis after hypogastric artery embolization for postpartum hemorrhage

Case Reports in Perinatal Medicine ◽

10.1515/crpm-2013-0017 ◽

2014 ◽

Vol 3 (1) ◽

Author(s):

Robin Julve ◽

Eva Meler ◽

Elena Murillo ◽

Bernat Serra

Keyword(s):

Cesarean Section ◽

Postpartum Hemorrhage ◽

Twin Pregnancy ◽

Rare Complication ◽

Skin Grafting ◽

Hypogastric Artery ◽

Vacuum Assisted Closure ◽

Artery Embolization ◽

Vacuum Assisted Closure Therapy

AbstractUterine or hypogastric artery embolization is a useful alternative to hysterectomy in the treatment of postpartum hemorrhage.Puerpera requiring a bilateral hypogastric artery embolization for postpartum hemorrhage after cesarean section in a term twin pregnancy. Unexpected unilateral buttock necrosis appeared 5 days later. Treatment consisted of debridement, the use of vacuum-assisted closure therapy and skin grafting.Buttock necrosis is a rare complication after hypogastric artery embolization in the treatment of postpartum hemorrhage.

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Spinal anesthesia for cesarean section in a woman with Kartagener’s syndrome and a twin pregnancy

International Journal of Obstetric Anesthesia ◽

10.1016/j.ijoa.2006.11.014 ◽

2007 ◽

Vol 16 (3) ◽

pp. 284-287 ◽

Cited By ~ 6

Author(s):

M. Gávai ◽

P. Hupuczi ◽

E. Berkes ◽

A. Beke ◽

E. Hruby ◽

...

Keyword(s):

Cesarean Section ◽

Spinal Anesthesia ◽

Twin Pregnancy ◽

Kartagener's Syndrome

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Iliofemoral-popliteal Phlebothrombosis in Twin Pregnancy Treated with Cesarean Section and Thrombectomy in the Same Act: A Case Report

American Journal of Perinatology ◽

10.1055/s-2006-939534 ◽

2006 ◽

Vol 23 (4) ◽

pp. 219-222

Author(s):

Dubravko Habek ◽

Mirna Vuković-Bobić ◽

Zoran Popović ◽

Mladen Pajtler ◽

Tomislav Kulaš ◽

...

Keyword(s):

Case Report ◽

Cesarean Section ◽

Twin Pregnancy

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Successful Management of a Complicated Mirror Syndrome: A Case Presentation

Case Reports in Clinical Practice ◽

10.18502/crcp.v4i2.1709 ◽

2019 ◽

Author(s):

Fatemeh Rahimi-Sharbaff ◽

Nafiseh Saedi

Keyword(s):

Conservative Treatment ◽

Cesarean Section ◽

Liver Enzyme ◽

Twin Pregnancy ◽

Successful Management ◽

Fetal Hydrops ◽

Case Presentation ◽

Cesarean Section Delivery ◽

Preeclamptic Patient ◽

Fetal Infection

Mirror syndrome is a rare but serious condition of pregnancy characterized by fetal hydrops of any cause and maternal edema that has severe maternal and fetal morbidity and mortality. In most cases, the pregnancy should be terminated to resolve the symptoms. Some cases with mirror syndrome resolve spontaneously due to the demise of the hydropic fetus or fetal infection with parvovirus. This case is a rare complicated mirror syndrome that managed conservatively up to 34 weeks and 3 days of gestation. This case was a unique Dichorionic Diamniotic (DCDA) twin pregnancy with mirror syndrome, that feticide of the hydropic fetus has resolved symptoms of mirror syndrome. Although the mother’s liver enzyme increased after 3 weeks of feticide, we managed to save pregnancy by conservative treatment until 34 weeks and 3 days of gestation. Finally, the mother had a cesarean section delivery. The baby is now 6 months old with normal neurodevelopmental parameters. This case suggests that preeclampsia can happen after feticide due to twin pregnancy and the retained placenta. If we consider this event, we can manage pregnancy conservatively as a preeclamptic patient.

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Clinical Study on Different Delivery Methods of Twin Pregnancy

American Journal of Perinatology ◽

10.1055/s-0041-1735492 ◽

2021 ◽

Author(s):

Liyan Hu

Keyword(s):

Cesarean Section ◽

Pregnancy Outcome ◽

Vaginal Delivery ◽

Twin Pregnancy ◽

Delivery Methods ◽

Preterm Premature Rupture ◽

Key Points ◽

Baseline Information ◽

The Difference ◽

Twin Pregnancies

Objective To investigate the effect of different methods of delivery on the outcome of twin pregnancies. Methods This is a retrospective cohort review of 627 twin pregnancies with delivery from January 2016 to December 2019. According to the clinical guidelines for cesarean section, the cesarean section and vaginal delivery groups were determined. Finally, the baseline information, delivery method, pregnancy outcome, and maternal and infant complications of the two groups were compared. Results For different delivery methods, the incidence of preeclampsia was significantly higher in the cesarean section group than in the vaginal delivery group (χ2 = 4.405, p < 0.05). There were 23 fetal growth ratios (FGR) in the cesarean section group, which were significantly higher than the vaginal delivery group (χ2 = 4.740, p < 0.05). However, the incidence of preterm premature rupture of membranes (PPROM) in the vaginal delivery group was significantly higher than in the cesarean section group (χ2 = 5.235, p < 0.05). In addition, the volume of postpartum bleeding in the vaginal delivery group was significantly higher than in the cesarean section group (t = 4.723, p < 0.001). The neonatal weights and 5-minute Apgar scores of the vaginal delivery group were lower than the cesarean section group, and the difference was statistically significant. In the vaginal delivery group, 48 and 26 neonates were transferred to the intensive care and neonatal units, respectively, which were significantly higher than in the cesarean section group (χ2 = 5.001, p < 0.05). Conclusion The major complications of a twin pregnancy are gestational diabetes mellitus and PPROM. Cesarean section can reduce the rate of neonatal asphyxia in twins and improve the pregnancy outcome. Key Points

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A screening and intervention program aimed to reduce mortality and serious morbidity associated with severe neonatal alloimmune thrombocytopenia

Blood ◽

10.1182/blood-2006-08-040121 ◽

2007 ◽

Vol 110 (3) ◽

pp. 833-839 ◽

Cited By ~ 174

Author(s):

Jens Kjeldsen-Kragh ◽

Mette Kjær Killie ◽

Geir Tomter ◽

Elzbieta Golebiowska ◽

Ingrid Randen ◽

...

Keyword(s):

Platelet Count ◽

Cesarean Section ◽

Pregnant Women ◽

Intracranial Hemorrhage ◽

Prospective Studies ◽

Twin Pregnancy ◽

Intervention Program ◽

Severe Thrombocytopenia ◽

Alloimmune Thrombocytopenia

Abstract The study's objective was to identify HPA 1a–negative women and to offer them an intervention program aimed to reduce morbidity and mortality of neonatal alloimmune thrombocytopenia (NAIT). HPA 1 typing was performed in 100 448 pregnant women. The HPA 1a–negative women were screened for anti–HPA 1a. In immunized women, delivery was performed by Cesarean section 2 to 4 weeks prior to term, with platelets from HPA 1a–negative donors reserved for immediate transfusion if petechiae were present and/or if platelet count was less than 35 × 109/L. Of the women screened, 2.1% were HPA 1a negative, and anti–HPA 1a was detected in 10.6% of these. One hundred seventy pregnancies were managed according to the intervention program, resulting in 161 HPA 1a–positive children. Of these, 55 had severe thrombocytopenia (< 50 × 109/L), including 2 with intracranial hemorrhage (ICH). One woman with a twin pregnancy missed the follow-up and had one stillborn and one severely thrombocytopenic live child. In 15 previous prospective studies (136 814 women) there were 51 cases of severe NAIT (3 intrauterine deaths and 7 with ICH). Acknowledging the limitation of comparing with historic controls, implementation of our screening and intervention program seemed to reduce the number of cases of severe NAIT-related complications from 10 of 51 to 3 of 57.

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A Case of Successful Twin Pregnancy Placed in Separate Horns of Bicornuate, Unicollis Uterus

Acta geneticae medicae et gemellologiae twin research ◽

10.1017/s0001566000000118 ◽

1998 ◽

Vol 47 (3-4) ◽

pp. 201-204 ◽

Cited By ~ 6

Author(s):

A. W. Kuczynski ◽

W. Szcześniak ◽

A. Szczygielski

Keyword(s):

Cesarean Section ◽

Twin Pregnancy

AbstractWe described a case of pregnancy, delivery and peurperium of 28 years old multipara with twins pregnancy in bicornuate, unicollis uterus. Each fetus was placed in separate horn of uterus. Biological mature pregnancy was delivered by cesarean section. During the peurperium the involution disturbances of one of the uterus horns were observed. The case was discussed in context of other similar anomalies.

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