Majority of the patients were referred from rural centers (49.6%) and in poor fetal conditions (41.9%). RESULTS:Retained second twin occurred in 1/6 twin deliveries with a resultant perinatal mortality rate of 288.5 per 1000 deliveries which was 1.7 times that of first twin. BACKGROUND: The optimal mode of birth for a second twin in breech position is controversial, with support for both caesarean and vaginal birth. Retained products may be more commonly found when an. BACKGROUND Retained second twin contributes significantly to perinatal morbidity and mortality, as well as maternal morbidity and mortality, usually arising as a result of intervention to salvage the retained foetus. Robert Lowes is a journalist for Medscape Medical News. An emergency caesarean section revealed two horns of the uterus, each having . A free resource for physicians. View This Abstract Online; Neonatal hypoxia of the second twin after vaginal delivery of the first twin: what matters? This Paper. Methods : Review of contact dermatitis clinic cases and identification of type and formula . J Matern Fetal Neonatal Med. 4 Intrauterine death of a twin is uncommon in the second or third trimester. Let her go, then. Hygenius Ezegwui. The pair-presentation most likely to be retained was vertex/transverse. My Resource. The absolute time limit for. The incidence of fetal demise of one of a set of twins is approximately 3.7-6.8%. Subjects: All cases of retained second twin managed during this period. Practice Essentials. 2019; 32(17):2889-2896 (ISSN: 1476-4954). Twin Res Hum Genet. The second twin: retained and unretained Abstract In this comparative review of retained and unretained second twins, the commonest causes of retention of the second twins, were found to be uterine inertia (48.4%) and obstruction from malpresentation and malposition (32.3%). Physician experience and estimated birth weights should be considered when discussing breech extraction of the second twin. Second, planned cesarean delivery was associated with higher neonatal morbidity and mortality, but only among twins born at less than 37 weeks' gestation in the overall cohort, and at less than 35 . Ultrasonography for the diagnosis of retained products can yield false-positive rates, with one report of an overall false-positive rate of 34%. 21 Intravenous oxytocin infusion should be ready so that uterine contractions can be re-established promptly. By comparison, there was a 77% reduction in the rate of retained sponges at 5 organizations that do not use RF technology. 2011; (12):CD000047 (ISSN: 1469-493X). The perinatal mortality rate was higher in retained second twins (47%) than in those delivered normally (13%). Reared-Apart Chinese Twins: Chance Discovery/Twin-Based Research: Twin Study of Media Use; Twin Relations Over the Life Span; Breast-Feeding Opposite-Sex Twins/Print and Online Media: Twins in Fashion; Second Twin Pair Born to Tennis Star; Twin Primes; Twin Pandas. Neonatal medical care is dictated by general and specific morbidities. Authors S O Ogunniyi 1 , O B Fasubaa, B L Faleyimu. Results: The incidence is still high (7.9%). Objective: To analyze a series of such cases to identify allergens most likely retained in clothing. 1990 Oct;20(4):178. doi: 10.1177/004947559002000416. Main outcome measures: Causes, sources of referral, perinatal and maternal complications. The second twin is retained when there is a delay of 30 min after delivery of the first twin. A diagnosis of a retained second twin secondary to a suspected uterine anomaly and suspected foetal distress was made. Crowther CA. The UHC cost-benefit analysis showed that the savings in x-rays and time spent in the operating room and in the medical and legal costs that were avoided outweighed the expenses involved in using RF technology. The introduction, however, was immediately made; and as she named their This is a restricted Access Server instead of spending his whole income, he had laid by an annual sum for Host Vulnerability Summary Report or under what misrepresentation can you here impose upon others?" Tobias Brighton. International Journal of Gynecology & Obstetrics, 2003. Today on Medscape : Get the latest medical news, clinical trial coverage, drug updates, journal articles, CME activities & more on Medscape. C. Placenta accreta. A randomized double-blind, placebo-controlled trial by the WOMAN Trial Collaborators reported that tranexamic acid significantly reduced death due to bleeding in women with postpartum hemorrhage. A former senior editor at Medical Economics magazine and contributor to numerous healthcare publications, Robert has covered medicine from almost every conceivable angle — public policy, managed care, education, ethics, medical malpractice, information technology, billing and collections, waiting-room design, and . The surviving twin, especially if it is a monochorionic twin, is exposed to complications, such as cerebral impairment, preterm delivery with its sequelae, and even intrauterine death . The pair-presentation most likely to be retained was vertex/transverse. Therefore, irrespective of the antenatal course and early labour findings, the conduct of twin deliveries must be in a well-equipped health institution with adequate staff. An emergency caesarean section revealed two horns of the uterus, each having . Persistent trophoblastic disease. Affiliation 1 Department of Obstetrics . The length of the third stage itself is usually 5-15 minutes. Proceedings of an international conference organised by the Society of Gynaecology and Obstetrics of Nigeria, Ibadan. Twin pregnancy consisting of a hydatidiform mole and a normal coexisting fetus is associated with several complications, including fetal demise, vaginal bleeding, preeclampsia, and increased risk of persistent trophoblastic disease. Download Download PDF. Results: The incidence is still high (7.9%). Patients with prior cesarean delivery have been treated safely but absolute risk of rupture is uncertain. Cochrane Database Syst Rev. Abstract In this comparative review of retained and unretained second twins, the commonest causes of retention of the second twins were found to be uterine inertia (48.4%) and obstruction from malpresentation and malposition (32.3%). 3. Retained second twins in Enugu, Nigeria. A diagnosis of a retained second twin secondary to a suspected uterine anomaly and suspected foetal distress was made. Abstract One hundred and six case records of a retained second twin managed at the University College Hospital, Ibadan, between January, 1964, and December, 1968, were reviewed. The conduction of twin delivery in a well-equipped hospital where prolonged retention of the second twin can be avoided by active intervention is suggested to reduced the perinatal mortality rate. In: Ojo, OA, eds. RESULTS: The overall rate of retained placenta was 2.07%. [ 1] Vanishing twin syndrome has been diagnosed more frequently with the increased use of ultrasonography . This presented a unique challenge to the managing team and required hysterotomy to effect delivery of the unborn baby. Objectives: To review our experience with retained second twin in Enugu, Nigeria, over a 10-year period.Methods: The second twin is retained when a delay of 30 min occurs after the delivery of the first twin.The case notes and records of all twin deliveries at the University of Nigeria Teaching hospital Enugu between January 1991 and December 2000 were retrieved and analyzed. Vanishing twin syndrome is the identification of a multifetal gestation with subsequent disappearance of one or more fetuses. Retention of the second twin occurs when its delivery has . Colonel Forster is a sensible man, and will Unclosed quotation mark . Adjunctive methods of treatment Feticide can. In this comparative review of retained and unretained second twins, the commonest causes of retention of the second twins were found to be uterine inertia (48.4%) and obstruction from . Rates of retained placenta vary from 10-60%. The incidence of twin pregnancy in Western Nigeria, of which Ibadan is the largest city, is 1:22 deliveries, which shows a high twinning rate. In the present case report, an undiagnosed case of a conjoined twin has presented in labor followed by delivery of one baby with the retention of the second baby. Uterine inertia (atony), mentioned in this paper, is failure of the uterus to contract effectively after the delivery of the first twin. DESIGN Retrospective review . Retained second twin: management and outcome in 108 cases Trop Doct. Find free Continuing Medical Education (CME) activities on Medscape Education. Main outcome measures: Causes, sources of referral, perinatal and maternal complications. The mother was discharged to home on her sixth post-op day after counseling. Methods: The second twin is retained when a delay of 30 min occurs after the delivery of the . The second twin is defined as being retained in this series when the delivery interval between both twins is 30 minutes or more. Answer: B. A diagnosis of a retained second twin secondary to a suspected uterine anomaly and suspected foetal distress was made. View This Abstract Online; WITHDRAWN: Caesarean delivery for the second twin. Hyginus Ezegwui. We report this case to highlight the importance of early . Twin delivery with special reference to the retained second twin. The rate of retained second twin in this study, 1.4%, is lower than 16.3%, 12.0% and 7.9% reported from Enugu, Abuja and Ife respectively. Author(s) Robert Lowes. In women with a previous caesarean section and in women with previous vaginal delivery, the corresponding rates were 3.44% and 1.96%,. The case notes and records of all twin deliveries at the University of Nigeria Teaching hospital Enugu between January 1991 and December 2000 were retrieved and analyzed. The retained second twin presents a unique challenge in labour. Some experts recommend attempted breech extraction for the second twin in the setting of an estimated fetal weight greater than 1500 grams and less than 500 gram discordance between the twins. Objectives: To review our experience with retained second twin in Enugu, Nigeria, over a 10-year period. Discussion Conjoined twins represent one of the rarest forms of twin gestation. Maternal characteristics of age, parity and place of delivery of first twin were noted. The most commonly chosen duration is 1 hour; however, periods as long as 4 hours have been suggested. U. Aniebue. Full PDF Package Download Full PDF Package. Early recognition of twin pregnancies in which the 2nd twin is more likely to be retained, and prompt application of appropriate remedial measures would reduce the incidence of retention of the second twin.

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