ABSTRACT
Monoamniotic twin pregnancies are relatively rare, occuring in 1 percentage. But perinatal mortality is 50-60 percentage. The high mortality rate has been attributed to preterm delivery, cord entanglement, twin-to-twin transfusion syndrome, intrauterine growth retardation and congenital anomalies. However, the desirable management plan of the monoamniotic twin pregnancies is still not established and there are controversies regarding the proper antepartum care of monoamniotic twins and the optimal timing and mode of delivery. We have experienced one case of monoamniotic twin without cord entanglement and both fetuses survival by cesarean section at 36+3 weeks, is reported with a brief review of the literatures.
Subject(s)
Female , Humans , Pregnancy , Cesarean Section , Fetal Growth Retardation , Fetofetal Transfusion , Fetus , Mortality , Perinatal Mortality , Pregnancy, TwinABSTRACT
Fetal bilateral renal agenesis is a lethal congenital anomaly characterized by bilateral pulmonary hypoplasia, deformities and death due to severe oligohydramnios. This syndrome is associated with malformations of genitourinary tract, cardiovascular system, vertebral bodies or imperforated anus in more than half of the affected individuals. An early and reliable prenatal diagnosis is extremely important because it may offer options for pregnancy termination as early as possible. The criteria for the ultrasonographic diagnosis of bilateral renal agenesis are severe oligohydramnios, nonvisualization of the bladder, empty renal fossae. But poor sonographic resolution of severe oligohydramnios makes it difficult to diagnose the disease. We present a case of bilateral renal agenesis diagnosed at the 32nd weeks gestation by using color doppler and "lying down" adrenal sign.
Subject(s)
Female , Pregnancy , Anal Canal , Cardiovascular System , Congenital Abnormalities , Diagnosis , Oligohydramnios , Prenatal Diagnosis , Ultrasonography , Urinary BladderABSTRACT
Our purpose was to compare the safety and efficacy of intravaginal misoprostol versus dinoprostone vaginal tablet for induction of labor at term pregnancies. Two hundred three patients with indications for induction of labor at term were randomly assigned to receive either intravaginal misoprostol or dinoprostone vaginal tablet. Fifty micrograms of misoprostol was placed in the posterior vaginal fornix every six hours, with a potential maximum of four doses. 3 milligrams of dinoprostone vaginal tablet was placed in the posterior vaginal fornix every eight hours, with a potential maximum of three doses. Further medication was withheld with the occurrence of spontaneous rupture of membrane, entry into adequate contraction pattern(twenty second sustained with two or more frequent uterine contraction in 10 minutes), nonreassuring FHR tracing, or delivery. Artificial membrane rupture with both study protocol was done at the discretion of the attending physician. After membrane rupture, in the cases of failure of active labor or arrest of dilation, oxytocin was administerated. Among those evaluated, 100 received misoprostol and 102 received dinoprostone. The average interval from start of induction to vaginal delivery was shorter in the misoprostol group(784.7 +/- 389.3 min) than in the dinoprostone group(988.3 +/- 369.5 min)(p<0.01). There was no significant difference in change of Bishop score between the two groups. No statistically significant differences were noted between two groups in case of need for oxytocin and oxytocin total dose, but significant difference was noted between two groups in case of indication for oxytocin augmentation. There were no significant differences in the routes of delivery. Intravaginal administration of misoprostol appears to be as effective as dinoprostone vaginal tablet for labor induction at full term pregnancies. Complications associated with prostaglndin administration were not statistically different between the two treatment groups.