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Gynécologie Obstétrique & Fertilité
Volume 31, n° 1
pages 46-48 (janvier 2003)
Doi : 10.1016/S1297-9589(02)00006-1
Received : 20 Mars 2002 ;  accepted : 5 September 2002
Accouchement différé d'une grossesse gémellaire
Delayed delivery in twin pregnancy

N.  Seince a * ,  F.  Aissaoui a ,  S.  Bolie b ,  Y.  Chitrit c ,  M.  Uzan a
aService de gynécologie-obstétrique, hôpital Jean-Verdier, avenue du 14-Juillet, 93140 Bondy, France 
bService de pédiatrie, hôpital Jean-Verdier, avenue du 14-Juillet, 93140 Bondy, France 
cService de gynécologie-obstétrique, hôpital André-Grégoire, 56, boulevard Boissière, 93105 Montreuil, France 

*Auteur correspondant.
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Nous rapportons l'observation d'une patiente primigeste, présentant une grossesse gémellaire spontanée bichorionique biamniotique. Après expulsion spontanée du premier jumeau à 20 SA et 2 j, l'expectative est adoptée et le deuxième jumeau naît à 31 SA et 3 j. Devant cette situation obstétricale peu fréquente et l'absence de consensus dans la littérature, nous discutons trois points : le cerclage, la tocolyse et l'antibiothérapie prophylactique. Nous précisons que la tentative d'un accouchement différé a pour but d'améliorer le pronostic foetal du deuxième jumeau en l'amenant à un terme viable et obtenir si possible une survie sans séquelles.

Mots clés  : Accouchement différé ; Cerclage ; Prématurité ; Tocolyse ; Antibiothérapie.

Abstract

We report the observation of a primigravid patient, presenting a spontaneous twin pregnancy bichorionic and biamniotic. After expulsion of the first twin at 20 weeks and two days, expectancy is adopted and the second twin is born at 31 weeks and three days. In front of this not so frequent obstetrical situation and the absence of consensus, we discuss three points: cerclage, tocolysis and the prophylactic antibiotherapy. We specify that the attempt at differed childbirth is aimed at improving the foetal prognosis of the second twin by bringing it into the viable term, as well as obtaining a survival with the least possible number of sequels.

Mots clés  : Delayed-interval delivery ; Cerclage ; Prematurity ; Tocolysis ; Antibiotherapy.




© 2002  Éditions scientifiques et médicales Elsevier SAS. All Rights Reserved.

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