Selective delivery in a twin gestation.
One or more infants of a multifetal pregnancy occasionally require delivery selectively because of in utero risk of fetal death in circumstances in which the sibling fetus appears well. At 26 weeks 5 days of gestation a small fundally placed twin in a dichorionic gestation had an estimated fetal weight of 650 g with decreased amniotic fluid and ominous Doppler velocity findings in his umbilical artery. A normally grown presenting sibling had reassuring fetal surveillance data. Over a 2-week interval the growth-restricted twin showed no growth, and his status deteriorated. He was selectively delivered by hysterotomy. Selective delivery may offer parents of multifetal gestations an additional option when 1 or more of their fetuses are at high risk for in utero death.
Porreco
R P
RP
Columbia Presbyterian/St. Luke's Medical Center, Denver, Colorado 80218, USA.
Sabin
E D
ED
Heyborne
K D
KD
Lingle
J R
JR
D000328:Adult; D036861:Delivery, Obstetric / Q000379:methods*; D004200:Diseases in Twins; D005260:Female; D005313:Fetal Death / Q000517:prevention & control*; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D012307:Risk Factors; D014599:Uterus / Q000601:surgery*