Survival of both twins in a pregnancy complicated by pre-viable cord prolapse at 21 weeks of gestation
-
Abdullah Alnoman
,
Ghazi Alsarraj
Abstract
Background
Umbilical cord prolapse is rare but a very serious obstetric emergency. Its incidence has declined over time and significant advances in its management have improved perinatal outcome.
Case presentation
A 38-year-old woman (gravida 3, para 0) conceived a dichorionic twin pregnancy through in vitro fertilization presented at 21 weeks of gestation with premature rupture of membrane of the presenting twin. At 21+4 weeks’ gestation, cord prolapse of the presenting twin into the vagina was identified by ultrasound. Parents chose conservative management, and planned cesarean section was done at 27+4 weeks.
Conclusion
Our case demonstrates that conservative management with measures to reduce the risks of infection and a planned delivery can result in positive outcomes even in cases where the cord prolapse occurs prior to viability.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
Ethical approval: The research related to human use has complied with all the relevant national regulations, institutional policies and has been conducted in accordance with the tenets of the Helsinki Declaration, and it has been approved by the authors’ Institutional Review Board or equivalent committee.
References
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- Case Reports – Obstetrics
- Fetal pulmonary choristoma: report of first case and literature review
- Ultrasound prenatal diagnosis of a de novo 14q distal duplication associated with foetal anomalies: a case report
- Prenatal diagnosis of Kleefstra syndrome
- Cardiac implant and the risk of infective endocarditis in pregnancy
- Iatrogenic fetal goiter. Conservative management and spontaneous resolution
- Management in cases of large uterine myomas in pregnancy
- Significantly enlarged varix in the free-loop of the umbilical cord during the second trimester
- A case report of co-infection with rhinovirus and SARS-CoV-2 in pregnancy
- Monoamniotic twins pregnancy complicated by a fetal congenital heart defect – a challenge for perinatal decisions
- Favorable outcome after nine minutes of shoulder dystocia preceded by a tight nuchal cord
- Circumvallate placenta and abnormal cord insertion as risk factors for intrauterine growth restriction and preterm birth: a case report
- A rare case of intra-uterine blood transfusion for fetal anemia caused by a giant placental chorioangioma
- Septated fetal bladder in a case of 2q13 deletion
- A case of prenatal diagnosis of single umbilical artery due to thrombosis diagnosed by the ultrasound finding of “wink-sign”
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