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Findings that shed new light on the possible pathogenesis of a disease or an adverse effect
Case report
Recovery of second trimester pre-eclampsia after fetal reduction of a triplet
  1. Jeske M bij de Weg1,
  2. Christianne J de Groot1,
  3. Eva Pajkrt2 and
  4. Marjon A de Boer1
  1. 1 Obstetrics and Gynaecology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
  2. 2 Obstetrics and Gynaecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
  1. Correspondence to Prof Dr Christianne J de Groot, cdegroot{at}me.com

Abstract

Women with a multiple pregnancy are at increased risk of developing hypertensive disorders of pregnancy. We describe a case of a dichorionic triamniotic triplet pregnancy complicated by severe hypertension, proteinuria and maternal symptoms, fitting with the diagnosis of pre-eclampsia, apart from the early gestational age of only 16 weeks. After reduction of the monochorionic pair, the disease resolved and pre-eclampsia was diagnosed again at 30 weeks of gestation, resulting in a delivery on maternal indication at 33 weeks of gestation. In a review of the literature, we found six papers including eight cases on multifetal pregnancy reduction on maternal indication. Multifetal pregnancy reduction resulted in a prolongation of pregnancy of two to 21 weeks and may be considered in extreme early onset pre-eclampsia in dichorionic multiple pregnancies.

  • Pregnancy
  • Obstetrics And Gynaecology

https://doi.org/10.1136/bcr-2018-227667

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    Footnotes

    • Contributors CJdeG and MAdeB were involved in the care and counseling of the patient. Thereby, they conceived and supervised this case report and review of the literature. EP performed procedure of the fetal reduction. JMbdW performed the review of the literature and wrote the manuscript. All authors contributed to the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Obtained.