Complicated Delivery of Twins Results in Death of Fetus

Case Overview

This case involves a thirty-two-year-old female who was pregnant with twins. The patient went into labor at twenty-four weeks gestation and ultrasound studies suggested that the babies had some bone length discrepancies. The patient was admitted with fetal monitoring ordered at three times per day and ultrasounds were done two times per week. The mother delivered thirteen days later after all attempts were made to prevent the premature labor. The ultrasound on the day of delivery showed no heart rate in the first twin and several complications in the second twin including dicrotic notching, epicord entanglement, and intermittent diastolic flow in the umbilical artery. It was at this point an emergency delivery was initiated. The physician on the service instructed the nurse to only monitor the first twin since the complications were more severe and that any change in one baby will occur in the other. However, the first twin was delivered with some complications and the second died in utero.