[Successful further prolongation of immature twin pregnancy by tocolysis and re-cerclage following unavoidable delivery of the first foetus after emergency cerclage (author's transl)].

The article reports on a twin pregnancy with EPH gestosis in a 20-year old primipara which could be prolonged by tocolysis and emergency cerclage after signs of premature delivery and prolapse of the amniotic sac in the 28th/29th pregnancy week. At the beginning of the 30th gestation week there was an unavoidable delivery of the first twin (920 g) who survived for 5 days only due to immaturity and hypotrophy. Directly after delivery of the first twin the pregnancy for the second twin was prolonged by renewed tocolysis and renewed circular suture of the cervix. This enabled the second child, whose growth had been retarded like that of the first one, to continue to grow for some time. Unavoidable delivery of the second twin (1,650 g) eventually occurred at the beginning of the 32nd week of pregnancy. The eutrophic child survived without the slightest complication. This case is presented in detail and discussed, including the histology of the placenta. The most important points for enabling the survival of a twin foetus are sufficient tocolysis, a satisfactory technique for occlusion of the os uteri, as well as exclusion and prevention of chorioamnionitis.