Jeonnam National University Hospital Medical Staff Successfully Deliver Full-Term Fetus Remaining After Elective Abortion Fire

Stillbirth delivery 117 days later... World record for longest pregnancy maintenance without cervical cerclage

Chonnam National University Hospital

[Asia Economy Honam Reporting Headquarters, Reporter Yoon Jamin] A woman in her 30s who lost one fetus during a twin pregnancy successfully delivered the surviving fetus at full term, drawing attention. Especially, cases of full-term delivery of the remaining fetus without cervical cerclage after stillbirth are very rare, attracting interest from the academic community.

According to Jeonnam National University Hospital (Director Ahn Younggeun) on the 25th, Ms. Kim (30) gave birth to a healthy baby boy weighing 3.26 kg via cesarean section at 38 weeks of pregnancy in the delivery room of Jeonnam National University Hospital on the morning of the 6th.

Ms. Kim initially conceived dizygotic twins through in vitro fertilization. However, on the 20th week and 2nd day of pregnancy, she experienced severe abdominal pain and was transferred to the High-Risk Pregnancy and Neonatal Integrated Care Center at Jeonnam National University Hospital for treatment. The next day, the amniotic membrane covering the fetus ruptured, leaving almost no amniotic fluid for the first fetus.

Accordingly, the medical staff at Jeonnam National University Hospital performed a selective abortion procedure on the fetus with the ruptured amniotic membrane at 20 weeks and 4 days to increase the survival rate of the second fetus. Ultimately, the first fetus was stillborn at 21 weeks and 2 days.

At that time, the placenta was left inside the uterus, and the umbilical cord of the first fetus was cut and sutured to maintain the pregnancy.

Dr. Kim Yoonha, head of the High-Risk Pregnancy and Neonatal Integrated Care Center and the attending physician, said, “It is very difficult to technically perform selective abortion on a fetus with ruptured membranes before the viability threshold of 24 weeks in dizygotic twin pregnancies and maintain the pregnancy to deliver the remaining fetus at full term. Especially in Ms. Kim’s case, the cervix was already significantly dilated with protruding membranes at admission, making it a very challenging situation that could have affected the second fetus as well. Therefore, selective abortion was the best option,” explaining the situation at the time.

Afterward, Ms. Kim continued to experience preterm labor contractions and was treated with uterine contraction inhibitors and antibiotics. Eventually, her health stabilized, and she was discharged at 34 weeks and 2 days of pregnancy. At 38 weeks, she delivered a baby boy via cesarean section.

Ms. Kim said, “At first, I went to the obstetrics clinic for mild abdominal pain, but suddenly it became an emergency, and I was transferred by ambulance to Jeonnam National University Hospital. I was so desperate thinking I might lose both twins. However, thanks to Dr. Kim’s quick judgment and excellent medical skills, we were able to save at least one child. With the care of the medical staff, I was discharged healthy, and I will raise the child well so that he can play a significant role in our society.”

Dr. Kim said, “A case of full-term delivery 117 days after stillbirth without cervical cerclage has not yet been reported in any international academic journal, making it a very difficult and rare miracle. The mother and her husband trusted and cooperated well with the medical staff, and because the second fetus endured well, we achieved a good outcome. We will continue to strive for healthy deliveries for mothers and fetuses in the future.”