title: Resolution of superimposed pre-eclampsia, and improvement in umbilical artery flow in a surviving twin after intrauterine demise of its co-twin.
abstract: Pre-eclampsia has a progressive clinical course, and is only cured by delivery of the placenta. We report a 30-year-old G1P0 with dichorionic twins, discordant growth and chronic hypertension who developed superimposed pre-eclampsia in her 21st week of gestation. After intrauterine demise of the severely growth-restricted twin, the superimposed pre-eclampsia resolved. The surviving twin initially had absent end diastolic flow, which resolved after the demise. A healthy 1935-g neonate with Apgar 9/9 was delivered at 34 weeks. Antenatal resolution of pre-eclampsia is extremely rare and resolution of superimposed pre-eclampsia has not, to our knowledge, been reported.
authors.affiliation: Department of Obstetrics and Gynecology, Maimonides Medical Center.
authors.forename: Deepa M
authors.initials: DM
authors.lastname: Narasimhulu
authors.affiliation: Department of Obstetrics and Gynecology, Maimonides Medical Center.
authors.forename: Scarlett
authors.initials: S
authors.lastname: Karakash
authors.affiliation: Department of Pathology, Maimonides Medical Center, Brooklyn, New York, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Rankin
authors.affiliation: Department of Obstetrics and Gynecology, Maimonides Medical Center.
authors.forename: Howard
authors.initials: H
authors.lastname: Minkoff
mesh_terms: D000328:Adult; D005260:Female; D005313:Fetal Death; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D007231:Infant, Newborn; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011247:Pregnancy; D059285:Pregnancy, Twin; D012075:Remission, Spontaneous; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*
keywords: dichorionic twins; intrauterine fetal demise; superimposed pre-eclampsia