A 23-year-old secundigravida with a known triplet gestation was admitted at 35 weeks gestation with rupture of membranes and mild uterine contractions. A previous pregnancy 2 years earlier had been delivered by cesarean section because of arrest of labor. The patient gave a history of occasional attacks of fainting during the last months of this pregnancy but could not give any details. Her physical examination and vital signs were normal; blood pressure was 126!62mmHg while sitting, heart rate was 96/ min and regular, and respiratory rate was 20/min. Sonography revealed three fetuses in breech presentations with estimated weights of approximately 2000gm each. Biophysical profile and nonstress tests showed good fetal responses. However, two transient episodes of maternal hypotension to 80/50mmHg occurred during the fetal surveillance; these appeared to be related to changes in maternal position.
KeywordsObstet Gynecol Multiple Gestation Breech Presentation Twin Gestation Uterine Relaxation
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