Clinical Case Database / Category: Patient Management
Selective termination in multiple pregnancy
Publication details
Dr Amit Verma, Dr Rita Arya
Foundation Years Journal, volume 8, issue 7, p.84 (123Doc Education, London, July 2014)
Abstract
We present a case of a Mono-chorionic Mono-amniotic twin pregnancy where one twin was diagnosed with severe bilateral ventriculomegaly and possible agenesis of corpus callosum at 20 weeks gestation while the second twin showed signs of growth restriction. The options of conservative management and selective termination of the abnormal foetus were discussed with the couple bearing in mind poor prognosis for both twins. The couple opted for selective termination of the abnormal foetus which was carried out in a tertiary centre. Subsequent scans showed improved growth parameters and placental function for the surviving twin. The pregnancy itself was complicated by pre term pre labour rupture of membranes at 26 weeks gestation which was managed conservatively. The patient went on to have a spontaneous normal delivery at 32 weeks gestation which was uneventful.
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Authors
Dr Amit Verma
Specialist Registrar O&G
Warrington and Halton Hospital NHS Foundation Trust
Lovely Lane, Warrington, WA5 1QG
amitverma@nhs.net
Dr Rita Arya
Consultant Obstetrician and Gynaecologist
Women’s Health, Warrington and Halton Hospital NHS Foundation Trust
Lovely Lane, Warrington, WA5 1QG
rita.arya@whh.nhs.uk
References
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4. Selective reduction in multiple gestations Best Pract Res Clin Obstet Gynaecol 2014 Feb;28(2):239- 47. doi: 10.1016/j.bpobgyn.2013.12.007. Epub 2014 Jan 8
5. Radiofrequency ablation vs bipolar umbilical cord coagulation in the management of complicated monochorionic pregnancies M. W. Bebbington et al Ultrasound in Obstetrics and Gynaecology Volume 40, Issue 3, pages 319–324, September 2012
6. Obstetric outcome after foetal reduction to singleton pregnancies L. De Catte and W. Foulon DOI: 10.1002/pd.285 Prenat Diagn 2002; 22: 206–210
7. Outcome following selective foetal reduction in monochorionic and dichorionic twin pregnancies discordant for structural, chromosomal and genetic disorders Elena Nobili et al Australian and Newzealand journal of Obstetrics and Gynaecology Volume 53, Issue 2, pages 114–118, April 2013
8. Ethical challenges in the management of multiple pregnancies: the professional responsibility model of perinatal ethics Chervenak et al J Perinat Med.2013 Jan;41(1):61-4. doi: 10.1515/jpm-2012-0056
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The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
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