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- Successful delayed-interval delivery performed 128 days after the vaginal delivery of the first fetus in a twin pregnancy
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Yu-Jin Koo
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Yeungnam Univ J Med. 2018;35(1):135-139. Published online June 30, 2018
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DOI: https://doi.org/10.12701/yujm.2018.35.1.135
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Abstract
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- There has been a significant increase in the number of multiple pregnancies that are associated with a high risk of preterm delivery among Korean women. However, to date, delayed-interval delivery in women with multiple pregnancy is rare. We report a case of delayed-interval delivery performed 128 days after the vaginal delivery of the first fetus in a dichorionic diamniotic twin pregnancy. The patient presented with vaginal leakage of amniotic fluid at 16 weeks of gestation and was diagnosed with a preterm premature rupture of membranes. Three days later, the first twin was delivered, but the neonate died soon after. The second twin remained in utero, and we decided to retain the fetus in utero to reduce the morbidity and mortality associated with a preterm birth. The patient was managed with antibiotics and tocolytics. Cervical cerclage was not performed. The second twin was delivered vaginally at 34 weeks and 5 days of gestation, 128 days after the delivery of the first-born fetus. This neonate was healthy and showed normal development during the 1-year follow-up period. Based on our experience with this case, we propose that delayed-interval delivery may improve perinatal survival and decrease morbidity in the second neonate in highly selected cases.
- Three cases of symphysis pubis separation associated with delivery.
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Jae Hong Ahn, Young Jin Jang, Dong Hyuk Lee, Young Gi Lee, Yoon Ki Park
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Yeungnam Univ J Med. 2000;17(1):93-98. Published online June 30, 2000
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DOI: https://doi.org/10.12701/yujm.2000.17.1.93
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Abstract
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- Symphysis pubis separation is an uncommon but not rare complication of delivery. Characteristic symptoms of symphyseal separation include suprapubic pain and tenderness which radiate to the back or legs, difficult ambulation, and bladder dysfunction. Clinical history, presenting symptoms, and response to therapy are sufficient to make the diagnosis, although radiographic documentation of symphyseal separation by x-ray or ultrasound are frequently used to confirm the diagnosis. The underlying etiology of symptomatic symphyseal separation has not been fully elucidated. Associations with macrosomia, pathological joint loosening, and increased force placed on the pelvic ring have been suggested as possible etiologies. Conservative therapy, including bed rest, pelvic binders, ambulation devices, and mild analgesics usually result in complete recovery within 4-16 weeks. Our experience of three cases of peripartum symphysis pubis separation delivered from 1998 to 1999 were reviewed with related articles.