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    Twin pregnancy in each half of a didelphys uterus with delayed delivery and review of literature

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        Abstract

        Didelphys uterus results from an incomplete fusion of mullerian ducts and corresponds to the class III of mullerian abnormalities of the American Fertility Society. We describe the case of a spontaneous twin pregnancy developed in each cavity of a didelphys uterus. At 29 weeks of gestation and 6 days, the patient had preterm rupture of membranes in the right horn. She went into spontaneous labor and delivered vaginally the first “right” twin. Delivery was complicated with post-partum hemorrhage on uterine atonia treated with a Bakri balloon. She was tocolyzed to pursue the fetal lung maturity of the second twin. She had a rupture of the second membranes at 30 weeks and 3 days and had a preterm vaginal delivery at 32 weeks and 1 day of the second twin. Twin pregnancy in both horns of a uterus is extremely rare, about 1 in 1,000,000. Pregnancies on congenital abnormalities of the paramesonephric duct present frequently poor obstetrical outcomes and many complications. There are no guidelines about the follow-up of these high-risk patients or the mode of delivery.

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        Most cited references 12

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        Clinical implications of uterine malformations and hysteroscopic treatment results

         G F Grimbizis (2001)
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          Reproductive impact of congenital mu¨ llerian anomalies

           F Raga,  C Bauset,  J Remohí (1997)
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            Independent uterine contractions in simultaneous twin pregnancy in each horn of the uterus didelphys

             Y Maki,  S. Furukawa (2014)
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              Author and article information

              Affiliations
              [1 ]Department of Obstetrics and Gynecology, Besancon University Medical Centre, 3 Fleming Boulevard, 25000 Besancon, France
              Author notes
              [* ]Corresponding author's e-mail address: didier.riethmuller@ 123456univ-fcomte.fr
              Contributors
              (View ORCID Profile)
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              Journal
              SOR-MED
              ScienceOpen Research
              ScienceOpen
              2199-1006
              26 March 2015
              : 0 (ID: e2dcb7a1-a94e-4970-b692-99a86a1e3628 )
              : 0
              : 1-4
              2677:XE
              10.14293/S2199-1006.1.SOR-MED.ASNJHF.v1
              © 2015 Levy et al.

              This work has been published open access under Creative Commons Attribution License CC BY 4.0 , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Conditions, terms of use and publishing policy can be found at www.scienceopen.com .

              Counts
              Figures: 2, Tables: 1, References: 12, Pages: 4
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              Original article

              Comments

              Level of importance: Low level of importance: it wouldn't provide useful insights in the management but considering the rarity of the condition it would be useful for knowing its possible clinical outcome.

              Level of validity: The article is well argued but the English level is very low and it would need corrections.

              Level of completeness: The authors reference the appropriate scholarly context. The authors provide or cite enough information to follow their findings or argumentation. They cite enough relevant publications in the field.

              o Level of comprehensibility: Is the language correct and easy to understand for an academic in the field? Are the figures well displayed and captions properly described? Is the article systematically and logically organized?

              2015-07-19 10:26 UTC
              +1

              Level of comprehensibility: The language needs corrections by a native English speaker. The figures are well displayed and properly described. Correcting the english sentences construction, it would be enough systematically and logically organized.

              2015-07-19 10:31 UTC

              PREVIOUS COMMENT CONTAINS SOME MISTAKES DUE TO COPY AND PAST ACTION

              This article deals with an interesting topic, although it does not provide important insights in the argument, It can be useful as shared experience on a quite rare clinical situation. Unfortunately, in the introduction and in the case report, the authors write in an incorrect English with frequent errors in grammar and sentence construction. Improper use of words/literary translation instead of correct medical terms/ errors in english sentences ( eg. boy, to do, use of saxon genitive.. ) are frequent. After the authors will have provided corrections with a native English speaker's help, the paper will be certainly more fluent and comprehensible.

              2015-07-05 14:08 UTC
              +1

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