Successful Interval Delivery With Emergency Cerclage Suture in the Postmenopausal Woman at Age of 57: A Case Report

Abstract

Pregnancy in women with advanced maternal age following ovum donation is associated with significant maternal and fetal complications which lead to increased risks of prematurity and lower birth weight. A 57-year-old postmenopausal, nulliparous woman with dichorionic pregnancy who had conceived with ovum donation, presented with preterm labor at 26 weeks and 5 days of gestation. Following rupture of the membrane of the protruding sac and delivery of the first twin, an emergency cerclage with tocolytics, antibiotics and corticosteroid therapy was initiated in order to improve the perinatal outcome of the second twin. The cerclage suture was removed after 4 days due to increasing serum C-reactive protein levels and maternal moderate respiratory distress. Both of the neonates survived following hospitalization for 6 weeks in the neonatal intensive care unit. The management described in this case report suggest that delayed interval delivery may be safe for the mother and salvative for the fetus; but both parents and doctors must be realized about its benefits and risks.




J Clin Gynecol Obstet. 2014;3(1):50-52
doi: http://dx.doi.org/10.14740/jcgo45w