Re: Interesting case: Twins, 19 weeks, PPROM,etc.
From: Anna Meenan, MD (annam@uic.edu)
Wed Mar 16 20:10:40 2005
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Good job! Keep us posted on progress.
--
Anna Meenan, MD
At Wed, 16 Mar 2005, Brian Fox wrote:
>
>Now for the rest of the story. And so many people think nothing much
>happens out in the boondocks.
>
>The patient felt something in the vagina about 36 hours after
>admission; this proved to be a solitary fetal leg. Still no evidence of
>infection; she was advised the loss of the leading twin was now inevitable, and
> loss of the 2nd was likely; she was having a few mild cramps. Over the
> course of the next 10 hours she reported some additional mild
>cramping; some additional sensations in the vagina that proved to be due to
> successive delivery of the other leg, then the torso, and, finally, the
> head. Fetus was stillborn. Cord was tied off just inside of the cervix
> with an Endoloop, and cut. The cervix then proceeded to close down.
> Remaining twin was active and viable. She was watched in the hospital
> overnight. Next morning, no cramps, no unusual discharge, Cervix
> visualized and seen to be closed.
>
> Seen in office Monday; no fever, no cramps, no unusual vaginal
>discharge. Cervix closed. Fetus B is active, strong and regular fetal heart tones. Advised to rest often; to place nothing in the vagina; take temperature twice/day; call if any feelings of ill health, etc. To be seen twice/week and PRN. She continues to smoke and indulge in her other
> usual habits. I told her that today she is a walking miracle, but could not provide any promise about the future.
>
> PS. Cowboy poetry festival is every year, last week of January; quite a gathering.
>
>--
> Brian W. Fox, MD, FACOG, Ruby Mountain OB-GYN
> 1995 Errecart Blvd., Suite 103
> Elko, NV 89801
>
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