Case of successfully delivered dicavitary twins in uterus didelphus

2021 ◽  
Vol 14 (11) ◽  
pp. e245139
Author(s):  
Ellie Barnes ◽  
Kate Walker ◽  
Hazem Mohamed Sayed ◽  
Amanda Green

Uterus didelphus is a congenital abnormality arising from failure of fusion of Mullerian ducts, creating two separate uterine horns, two cervices and, in some cases, a vagina divided by a longitudinal septum. In this case, a 26-year-old woman with previously undiagnosed uterus didelphus spontaneously conceived dicavitary twins. Although initially wanting a vaginal birth, when both twins were in a breech presentation, a caesarean section was performed at 36 weeks, delivering two healthy babies. We will discuss the risk of obstetric complications in uterus didelphus and the challenges surrounding a vaginal delivery.

2013 ◽  
Vol 20 (05) ◽  
pp. 759-764
Author(s):  
SANA ZAHIRUDDIN ◽  
SUMERA RAUF QURESHI ◽  
UMER FAROOQ

Background: Cesarean section is the commonest obstetrical procedure, associated with increase in maternal morbidity,the cesarean section rate is steadily on the rise in our country which can give rise to a number of complications. Objective: To determinethe factors associated with successful vaginal delivery after previous cesarean section. Study Design: Cross sectional study. Period:May 2009 to October 2009. Setting: Liaquat university hospital, Hyderabad. Material and Methods: a total of 96 women which fulfilledthe selection criteria were included in the study. Results: The women included in the study had a mean age of+SD(range),29.94+4.41successful vaginal birth was observed in 57(59.5%) women and 39(40.6%) had an emergency repeat cesareandelivery. The factors favoring successful vaginal delivery were history of previous vaginal delivery and previous cesarean due to fetaldistress or breech presentation, and patients having cesarean due to non progress of labor and no prior vaginal delivery were less likely tohave a successful vaginal birth after having previous cesarean delivery. Conclusions: vaginal birth after caesarean section can berecommended in patients having prior vaginal delivery and previous caesarean due to fetal distress and breech presentation.


2013 ◽  
Vol 25 (1) ◽  
pp. 14-17
Author(s):  
R Rahman ◽  
NN Khanam ◽  
N Islam ◽  
KF Begum ◽  
HH Pervin ◽  
...  

The study, conducted in the tertiary care hospital of Dhaka Bangladesh, describes the outcome of vaginal birth after caesarean section (VBAC) in women with a previous caesarean. A prospective study was carried out from 1st January 2007 to 31st December, 2007 on 126 women with one prior lower segment cesarean section (LSCS) for a nonrecurrent cause. All unbooked women and those with estimated fetal weight more than 3.5 kg, breech presentation, history of postoperative wound infection after previous LSCS, anemia (Hb < 10 gm%), pregnancy induced hypertension, diabetes, heart disease, renal disease, cephalopevic disproportion abnormal presentation and placenta praevia were excluded from the study. An informed consent was taken for allowing a trial of vaginal delivery. Spontaneous onset of labor was awaited up to 41 weeks. Induction of labor was considered only in highly selected cases. Labor was constantly supervised by competent staff and meticulously monitored by cardiotocography (CTG). Out of the 126 women enrolled for the study, 26 had to leave the station leaving a total of 100 patients; 72 patients underwent elective repeat C/S, 28 patients (28%) of these underwent trial of labour, among them 15 had successful vaginal delivery (53.57) but 13 patients failed the attempt and had to undergo emergency caesarean section. To assist in the 2nd stage of labour, 6 had ventouse application. In total 85 cases needed repeat caesarean section. Among the cases there was one case of scar dehiscence (6.6%), one case of cervical tear (6.6%), two cases of manual removal of placenta (13.3%), one case of post partum hemorrhage (6.6) and one case of puerperal pyrexia (6.6).Perinatal morbidity was comparable with the elective repeat C/S group. VBAC should be considered in cases of previous one cesarean delivery for nonrecurrent indication. DOI: http://dx.doi.org/10.3329/medtoday.v25i1.15902 Medicine Today 2013 Vol.25(1): 14-17


2016 ◽  
Vol 2 (1) ◽  
pp. 153
Author(s):  
Tomescu Cezar Laurentiu ◽  
Rodica Sîrbu ◽  
Emin Cadar ◽  
Brezeanu Dragos ◽  
Aneta Tomescu

The incidence of breech presentation is approximately 3,97%. Breech presentation is considered as being “borderline eutocic” and it requires carefully monitoring both the foetus and the mother. The aim of the current paper is to evaluate the preffered method of delivery in case of breech presentation. The paper presents a retrospective study performed in the Obstetrics and Gynaecology Departments of the County Emergency Clinical Hospital “Sf. Apostol Andrei” in Constanta, during a period of 5 years (2010-2014). The methods of birth were analyzed for a lot of 1104 patients with breech presentation with ages ranging between 16 and 44 years old. The total number of patients who gave birth through vaginal delivery was of 139 patients, amounting to 12.59% of the total population sample. The number of patients that gave birth through C-section was 965, which amounts to 87.4% of the total population sample. Birth through C-section is preferred by both obstetricians and patients alike, due to the fact that vaginal delivery is associated with a higher foetal risk in breech presentation.


2019 ◽  
Vol 31 (1) ◽  
pp. 23-26
Author(s):  
Mahe Jabeen ◽  
Sabiha Shimul ◽  
Ummay Salma ◽  
Jebunnesa

Introduction: Compared with a fetus with cephalic presentation, a breech fetus faces increased risk during labour and delivery of asphyxia from cord compression and of traumatic injury during delivery of the shoulders and head. Caesarean section avoids most of this risk. The purpose of this study was to evaluate the feasibility of vaginal delivery of uncomplicated singleton breech presentation by evaluating early neonatal morbidity and mortality as well as maternal morbidity following vaginal and caesarean delivery for breech presentation. Materials and Methods: This is a cross sectional comparative study.104 women with singleton breech presentation at term in labour were included consequetively in labour ward of Institute of Child and Mother Health (ICMH). Informed consent was taken from them. Neonatal and maternal outcome were recorded and statistical analysis was done using SPSS version 22. Results: APGAR at 5 min and Neonatal Intensive Care Unite (NICU) admission were not affected by mode of delivery. Long term neonatal outcome is similar in either mode of delivery. Maternal morbidity and duration of hospital stay is increased in caesarean births. Conclusion: Neonatal outcome did not depend on mode of delivery though maternal morbidity and cost of care is increased following Caesarean Section. Proper selection of cases and by improving skill & confidence in new generation obstetrician, vaginal delivery of singleton fetuses in breech presentation at term remains a safe option that can be offered to a woman in a tertiary care centre. Medicine Today 2019 Vol.31(1): 23-26


The Lancet ◽  
2000 ◽  
Vol 356 (9239) ◽  
pp. 1375-1383 ◽  
Author(s):  
Mary E Hannah ◽  
Walter J Hannah ◽  
Sheila A Hewson ◽  
Ellen D Hodnett ◽  
Saroj Saigal ◽  
...  

2014 ◽  
Vol 63 (5) ◽  
pp. 58-63
Author(s):  
Olga Petrovna Lebedeva ◽  
Olesya Nikolaevna Ivashova ◽  
Sergey Petrovich Pakhomov ◽  
Mikhail Ivanovich Churnosov ◽  
Nataliya Ivanovna Samborskaya ◽  
...  

The Background: Antimicrobial peptides are first line of defense for mucosa against viruses, bacteria, protozoa and fungi. Meanwhile, expression of antimicrobial peptides in postpartum period has not been studied. Objective: To estimate the expression of mRNA of antimicrobial peptides in epithelium of the cervix uteri after caesarean section and vaginal birth 3 or 4 days after delivery. Materials and methods: The data-sample consisted of 17 women after caesarean section and 46 women after vaginal delivery examined on days 3 or 4 of postpartum period. Quantitative reverse transcription PCR method was used to study mRNA expression of antimicrobial peptides. Statistical analysis was performed using Mann-Whitney criteria. Results: It was shown that higher level of expression of SLPI, HNP3, HD6 and HBD4 in the endocervix was present in women who delivered via caesarean section compared with those who had vaginal delivery. Conclusion: Women who underwent caesarean section exhibited increased expression of antimicrobial peptides compared to those who had vaginal birth. This increased expression can be attributed to multiple reasons such as differences in vaginal microflora restoration, different changes in hormone levels and also due to surgical trauma after operative delivery. The use of antimicrobial peptides can give new opportunities for prophylaxis and treatment of septic complications that occur in postpartum period.


Clinical Risk ◽  
2007 ◽  
Vol 13 (4) ◽  
pp. 127-130 ◽  
Author(s):  
Leroy Edozien

With rising Caesarean section (CS) rates, more women are having to consider the choice between an elective CS and a vaginal delivery (VBAC) in their subsequent pregnancy. This paper argues that there is an unmet need for clinicians to provide sufficient information to women in this position, so that the woman's choice can be an informed one. Consent should be evidence-based, but there are currently no published random-allocation studies comparing VBAC with elective repeat CS. However the available evidence could be better used by clinicians to facilitate informed choice.


2001 ◽  
Vol 56 (3) ◽  
pp. 132-134 ◽  
Author(s):  
Mary E. Hannah ◽  
Walter J. Hannah ◽  
Sheila A. Hewson ◽  
Ellen D. Hodnett ◽  
Saroj Saigal ◽  
...  

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