Delayed-interval delivery of an in vitro-fertilized triplet pregnancy with premature rupture of membranes in the second trimester.
BACKGROUND
The incidence of multiple pregnancies is increasing with the availability of assisted reproductive techniques. Preterm labor and preterm rupture of membranes are major complications in such pregnancies. Preterm delivery of the first fetus is often followed by delivery of the remaining fetuses. However, conservative management in such circumstances might allow for fetal lung maturity in the remaining fetuses.


METHODS
We present a case of conservative management of an in vitro-fertilized triplet pregnancy with early loss of the leading triplet. A 33-year-old woman in the 21st week of a triplet pregnancy delivered her one of the fetuses, 4 days after the preterm rupture of membranes. To save the surviving fetuses, ligation of the umbilical cord at the cervical level was performed. Patient received antibiotics, tocolytics and corticosteroids after then. The second and the third fetuses were successfully delivered by cesarean section in the 28th week of pregnancy, 43 days after the first fetus was born.


CONCLUSIONS
We can improve the life expectancy of the retained fetuses by conservative management using tocolytics, antenatal steroids to stimulate lung maturation and antibiotics following the delivery of the first fetus.
Department of Obstetrics and Gynecology, Faculty of Medicine, Trakya University, Edirne, Turkey.
Mehmet
M
Ali Yuce
Aysun
A
Aybatli
Petek Balkanli
PB
Kaplan
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D002585:Cesarean Section; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000503:physiopathology*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D007752:Obstetric Labor, Premature / Q000628:therapy*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011272:Pregnancy, Multiple / Q000502:physiology*; D015149:Tocolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*
D000305:Adrenal Cortex Hormones; D015149:Tocolytic Agents