Delayed delivery of surviving triplet after fetal reduction and spontaneous abortion

In multiple pregnancies, survival of remaining fetuses after premature death and delivery of one fetus is uncommon. We report a case of a triplet pregnancy that was reduced to twins at the 14th gestational week and then had preterm premature rupture of membranes and intrauterine fetal death of one twin at the 17th gestational week. To save the surviving fetus, delivery of the dead fetus and ligation of the umbilical cord at the cervical level were performed. We also performed McDonald cervical cerclage to keep the placenta of the dead fetus as well as that of the surviving one in the uterine cavity. After a series of aggressive procedures, including immediate administration of tocolytic agents, and antibiotic prophylaxis to prevent infection and preterm labor, the surviving fetus was delivered vaginally 73 days later due to intractable uterine contractions. After a 10-week hospital stay, the infant boy, weighing 2,500 g, was discharged without any sequelae. To our knowledge, this was the longest interval between deliveries in a triplet pregnancy reported in Taiwan. With adequate intensive management, a satisfactory outcome of the fetus and mother in such cases is possible.     

Retinopathy of prematurity in Frederiksborg County 1988-1990. A prospective investigation, an update

A report is given of retinopathy of prematurity findings in a Danish county (pop. 342,000) for birth years 1988-90. Out of 12,116 liveborn infants 200 were followed with eye controls during (at least) the first 3 months. In 135 gestational age and/or birth weight were below 32 weeks/1750 g. Twenty-five had ROP stage 1-2 with uneventful regression. Out of 5 with at least stage 3 ROP 2 had spontaneous regression. Three had cryotherapy; two acquired unilateral blindness, one myopia of prematurity. As part of an ongoing prospective investigation the visual results denote progress as compared to the serious results from the preceding 6 years (6 blind children). For 1982-90 the pooled ROP blindness rate amounted to 18.7/100,000 liveborn, a frequency only to be surpassed by the neighbouring Copenhagen area. Considering correct timing of cryotherapy close observation of small premature infants is recommended. At present our screening limits are 32 weeks gestational age/1750 g birth weight.