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[Successful postponement of delivery in twin pregnancy].

OBJECTIVE
Description of twin pregnancy after IVF preterm rupture of membranes of fetus A in 22nd gestational week. Abortion of fetus A and successful delayed delivery of twin B.


DESIGN
Case report.


SETTING
Obstetrics and Gynecology Department, 2nd Medical Faculty Charles University and Faculty Hospital Motol, Obstetrics and Gynecology Department, 1st Medical Faculty Charles University and General Faculty Hospital, Prague.


METHODS
Patient A. S. 34 years old, admitted to the hospital in 23rd gestational week with preterm rupture of membranes of fetus A, after appearing spontaneous uterine contractions terminated the abortion of fetus A. The uterine contractions stopped with toxolytics and after one week of expectation interval the cerclage suture of cervix was performed. The following course of pregnancy was protected with antibiotics and 48 hours toxolysis with beta mimetics. The pregnancy continued without any serious complications till 37th gestational week, when infectious markers elevated. Cerclage suture was taken away and after 12 hours interval the labor started. The labor was terminated with s.c. because of imminent fetal hypoxia.


CONCLUSION
After the abortion of twin A we succeeded to delay delivery interval for 4 months. The borderline mature neonate was born in good clinical condition and survived without any serious complications.