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Challenge in the Management of Twin Pregnancy with Anencephaly of One Fetus in a Low- Income Country: A Case Presentation

Received: 11 March 2019     Accepted: 23 April 2019     Published: 11 June 2019
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Abstract

Anencephaly of one twin is a frequent congenital abnormality in a twin pregnancy and it’s associated with a poor prognosis of this pregnancy. In developed countries, the goal standard management calls for an interventional fetal medicine either by injection of a cardiotoxic or by intervention on the umbilical cord. Another option is an expectative management with strict follow-up of pregnant women and delivery organized in a level 3 maternity. There is still a challenge in the management of such high risk pregnancy in low income countries. A 37 years-old female, G3P2002, referred from a clinic for the better management of a 28 weeks and 4 days twin pregnancy in labor. Obstetrical ultrasonography realized in the second trimester revealed dichorionic-diamniotic pregnancy and the presence of anencephaly with hydramnios of one twin. The expectative approach was adopted for the management of this high risk pregnancy, unfortunately the death of the fetus occurred despite all the care provided. This case brings to lamp light the difficulties encountered in providing standard obstetrical care for high risk pregnancies in resource limited settings.

Published in Journal of Gynecology and Obstetrics (Volume 7, Issue 3)
DOI 10.11648/j.jgo.20190703.15
Page(s) 81-84
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Anencephaly, Twin Pregnancy, Low Income Country

References
[1] Grignon A, Dubois J. Echographie des grossesses gémellaires. Journal de radiologie. 2002;83: 1899-908.
[2] Mohammed. A, Naima. C, Loubna. B. Epidémiologie et facteurs de risque des anomalies de fermeture du tube neural: données marocaines. Panafrican Medical Journal. 2015; 22:43.
[3] Annelies Lust, Luc De Catte, Liesbeth Lewi. Monochorionic and dichorionic twin pregnancies discordant for fetal anencephaly: a systematic review of prenatal management options. Prenat Diagn. 2008; 28: 275–279.
[4] Amadou A, Sonhaye L, Douaguibe B. Anencéphalie sur grossesse gémellaire: une série de six cas; Medecine et Sante´ Tropicales. 2013; 23: 185-188.
[5] Mohammed Amine Radouani1, Naima Chahid1, Loubna Benmiloud et alEpidémiologie et facteurs de risque des anomalies de fermeture du tube neural: données marocaines. Panafrican Medical Journal;2015; 22:43.
[6] Lipitz S, Meizner I, Yagel S, Shapiro I, Achiron R, Schiff E. Expectant management of twin pregnancies discordant for anencephaly. ObstetGynecol. 1995; 86:6; 969–972.
[7] Gaigi SS, Aida M, Sami J. Aspects foetopathologiques de 97 cas d’anencephalie: Etude du CMNR Tunis. Tunis Med. 2000; 78: 653-7.
[8] Robyr R, Yamamoto M, Ville Y. Selective fetocide in complicated monochorionic twin pregnancies using ultrasoundguided bipolar coagulation. British journal of obsteric and gynaecology. 2005; 112: 1344–1348.
[9] Delabaere A, Lemery D, Laurichesse H. J Gynecol Obstet Biol Reprod. 2010;39:S1-S342.
[10] Eddleman KA, Stone JL, Lynch L, Berkowitz RL. Selective termination of anomalous fetuses in multifetal pregnancies: two hundred cases at a single center. Am J ObstetGynaecol. 2002; 187: 1168–1172.
[11] De la Calle M, Arrieta S, Herro B. Dichorionic twin pregnancy discordant for anacephaly: two cases with different management; ClinExpObstet Gynecol. 2014; 41(2): 208-10.
Cite This Article
  • APA Style

    Romaric Joel Momo, Julius Dohbit Sama, Esther Meka, Mazou Ngou Temgoua, Pascal Foumane. (2019). Challenge in the Management of Twin Pregnancy with Anencephaly of One Fetus in a Low- Income Country: A Case Presentation. Journal of Gynecology and Obstetrics, 7(3), 81-84. https://doi.org/10.11648/j.jgo.20190703.15

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    ACS Style

    Romaric Joel Momo; Julius Dohbit Sama; Esther Meka; Mazou Ngou Temgoua; Pascal Foumane. Challenge in the Management of Twin Pregnancy with Anencephaly of One Fetus in a Low- Income Country: A Case Presentation. J. Gynecol. Obstet. 2019, 7(3), 81-84. doi: 10.11648/j.jgo.20190703.15

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    AMA Style

    Romaric Joel Momo, Julius Dohbit Sama, Esther Meka, Mazou Ngou Temgoua, Pascal Foumane. Challenge in the Management of Twin Pregnancy with Anencephaly of One Fetus in a Low- Income Country: A Case Presentation. J Gynecol Obstet. 2019;7(3):81-84. doi: 10.11648/j.jgo.20190703.15

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  • @article{10.11648/j.jgo.20190703.15,
      author = {Romaric Joel Momo and Julius Dohbit Sama and Esther Meka and Mazou Ngou Temgoua and Pascal Foumane},
      title = {Challenge in the Management of Twin Pregnancy with Anencephaly of One Fetus in a Low- Income Country: A Case Presentation},
      journal = {Journal of Gynecology and Obstetrics},
      volume = {7},
      number = {3},
      pages = {81-84},
      doi = {10.11648/j.jgo.20190703.15},
      url = {https://doi.org/10.11648/j.jgo.20190703.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20190703.15},
      abstract = {Anencephaly of one twin is a frequent congenital abnormality in a twin pregnancy and it’s associated with a poor prognosis of this pregnancy. In developed countries, the goal standard management calls for an interventional fetal medicine either by injection of a cardiotoxic or by intervention on the umbilical cord. Another option is an expectative management with strict follow-up of pregnant women and delivery organized in a level 3 maternity. There is still a challenge in the management of such high risk pregnancy in low income countries. A 37 years-old female, G3P2002, referred from a clinic for the better management of a 28 weeks and 4 days twin pregnancy in labor. Obstetrical ultrasonography realized in the second trimester revealed dichorionic-diamniotic pregnancy and the presence of anencephaly with hydramnios of one twin. The expectative approach was adopted for the management of this high risk pregnancy, unfortunately the death of the fetus occurred despite all the care provided. This case brings to lamp light the difficulties encountered in providing standard obstetrical care for high risk pregnancies in resource limited settings.},
     year = {2019}
    }
    

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    AU  - Romaric Joel Momo
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    AB  - Anencephaly of one twin is a frequent congenital abnormality in a twin pregnancy and it’s associated with a poor prognosis of this pregnancy. In developed countries, the goal standard management calls for an interventional fetal medicine either by injection of a cardiotoxic or by intervention on the umbilical cord. Another option is an expectative management with strict follow-up of pregnant women and delivery organized in a level 3 maternity. There is still a challenge in the management of such high risk pregnancy in low income countries. A 37 years-old female, G3P2002, referred from a clinic for the better management of a 28 weeks and 4 days twin pregnancy in labor. Obstetrical ultrasonography realized in the second trimester revealed dichorionic-diamniotic pregnancy and the presence of anencephaly with hydramnios of one twin. The expectative approach was adopted for the management of this high risk pregnancy, unfortunately the death of the fetus occurred despite all the care provided. This case brings to lamp light the difficulties encountered in providing standard obstetrical care for high risk pregnancies in resource limited settings.
    VL  - 7
    IS  - 3
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Author Information
  • Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaoundé, Cameroon

  • Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaoundé, Cameroon

  • Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaoundé, Cameroon

  • Public Health Department, Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaoundé, Cameroon

  • Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaoundé, Cameroon

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