Spontaneous Twin Pregnancy After Oophoropexy and Pelvic Radiation for Rectal Cancer.
BACKGROUND
Pregnancy after adulthood pelvic radiation is rare. There is a paucity of literature to guide preconception counseling and pregnancy management for these patients.


METHODS
A 36-year-old woman, gravida 2 para 1001, was referred at 28 weeks of gestation with spontaneous twins, preterm premature rupture of membranes, and a history of rectal cancer that had been treated 3 years previously with oophoropexy, chemoradiation, and abdominal perineal resection. Delivery was complicated by difficult fetal extraction and resulted in the demise of twin A.


CONCLUSIONS
Pregnancy after adulthood pelvic radiation is a potentially morbid event. Patients should be counseled about the potential delivery complications as well as the need for contraception after oophoropexy with intact fallopian tubes.
Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington.
Kaitlyn
K
Wald
Tom
T
Easterling
Elizabeth M
EM
Swisher
D000328:Adult; D002585:Cesarean Section; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D006801:Humans; D007231:Infant, Newborn; D010052:Ovariectomy; D018743:Perinatal Care; D011184:Postoperative Period; D011247:Pregnancy; D059285:Pregnancy, Twin; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012004:Rectal Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D014427:Twins