title: Salvaging twin 2 after abortion of twin 1: a case report.
abstract: We present intentional delayed delivery of twin 2 after a spontaneous membrane rupture and abortion oftwin1 in a dichorionic twin pregnancy at 14 weeks. As signs of infection were missing, we adopted a conservative (not expectant) management. The pregnancy was prolonged to 35 weeks' gestation. In the absence of additional risk factors, the role of conservative management of multiple pregnancies after loss of one fetus in prolonging the pregnancy to fetal viability in resource-poor setting is highlighted. The gained gestational age of 20 weeks and 4 days (144 days in all), for the remaining fetus and the healthy mother and child pair after delivery at 35 weeks are discussed. The perinatal, economic and psychological implications are highlighted. The importance of good clinical assessment in the diagnosis of cervical incompetence and using ultrasound scan as a complimentary instrument is emphasized.
authors.affiliation: Department of Obstetrics and Gynecology, University ofBenin Teaching Hospital, Benin City, Nigeria. jonakewhor@yahoo.com
authors.forename: J U E
authors.initials: JU
authors.lastname: Onakewhor
authors.forename: O
authors.initials: O
authors.lastname: Ohiosimuan
authors.forename: A N
authors.initials: AN
authors.lastname: Onyiriuka
mesh_terms: D000022:Abortion, Spontaneous / Q000473:pathology*; D000328:Adult; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000473:pathology / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D007752:Obstetric Labor, Premature / Q000473:pathology / Q000628:therapy; D010920:Placenta / Q000473:pathology; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011272:Pregnancy, Multiple; D016879:Salvage Therapy / Q000379:methods*; D014427:Twins