Volume 8, Issue 4, July 2020, Page: 113-116
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
Eka Po, Department of Obstetrics and Gynaecology, Benue State University Teaching Hospital, Makurdi, Nigeria
Swende Tz, Department of Obstetrics and Gynaecology, Benue State University Teaching Hospital, Makurdi, Nigeria
Ojabo Oa, Department of Obstetrics and Gynaecology, Benue State University Teaching Hospital, Makurdi, Nigeria
Hembah-Hilekaan Sk, Department of Obstetrics and Gynaecology, Benue State University Teaching Hospital, Makurdi, Nigeria
Ornguze Aa, Department of Obstetrics and Gynaecology, Benue State University Teaching Hospital, Makurdi, Nigeria
Dabit Oj, Department of Paediatrics, Benue State University Teaching Hospital, Makurdi, Nigeria
Maanongun Mt, Department of Obstetrics and Gynaecology, Benue State University Teaching Hospital, Makurdi, Nigeria
Okoh Ea, Department of Obstetrics and Gynaecology, Benue State University Teaching Hospital, Makurdi, Nigeria
Adia Jt, Department of Obstetrics and Gynaecology, Benue State University Teaching Hospital, Makurdi, Nigeria
Received: Jul. 18, 2020;       Accepted: Jul. 29, 2020;       Published: Aug. 20, 2020
DOI: 10.11648/j.jgo.20200804.18      View  59      Downloads  23
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.
Keywords
Single-twin Intrauterine Death, Conservative Management, Multidisciplinary Approach, Chorionicity, Maternal Coagulopathy, Fetus Papyraceus
To cite this article
Eka Po, Swende Tz, Ojabo Oa, Hembah-Hilekaan Sk, Ornguze Aa, Dabit Oj, Maanongun Mt, Okoh Ea, Adia Jt, 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. Vol. 8, No. 4, 2020, pp. 113-116. doi: 10.11648/j.jgo.20200804.18
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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