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임신 16 주의 제 1 쌍태아 분만 후 적극적 치료에 의한 제 2 쌍태아 임신 기간 연장
김인현,김인현 ( In Hyun Kim ),김정환 ( Jeong Hwan Kim ),전혜선 ( Hye Sun Jun ),계정웅 ( Jeong Woong Kay ),윤태기 ( Tae Ki Yoon ) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.3
Intentional delay of aftercoming siblings in multiple gestation is an infrequent occurrence in obstetrics. After delivery of an immature twin, conventional treatment calls for induction and delivery of the aftercoming sibling. However, several case reports have documented the feasibility of an expectant management. And also, as in our case, an aggressive treatment consisting of cerclage, tocolysis, and broad-spectrum antibiotics has been shown to prolong pregnancy. We experienced an unavoidable delivery of a nonviable first twin after premature rupture of membranes at 16 weeks' of gestation. The placenta was left undisturbed. Twin B was confirmed to be alive within the intact second sac. Tocolysis was started and cervical cerclage was done directly after delivery of twin A. Pregnancy was successfully prolonged, which enabled the second fetus to remain in utero and grow for another 145 days. To our knowledge, this was the longest interval between deliveries in a twin pregnancy reported in the literature. A healthy 3,050 gm male was delivered by cesarean section at 37 weeks' of gestation. Below we present this case in detail and discussed with respect to the aggressive approach undertaken to prolong gestation.