# Emergency Cesarean Section in a Dichorionic Diamniotic Twin Pregnancy With Hydrops Fetalis: A Report of a Critical Case

## TL;DR

A 41-year-old woman with a complicated twin pregnancy underwent an emergency cesarean section due to hydrops fetalis and footling presentation.

## Contribution

This report highlights the management and outcomes of a high-risk dichorionic diamniotic twin pregnancy with hydrops fetalis.

## Key findings

- Emergency cesarean section was performed at 31.2 weeks due to footling presentation and hydrops fetalis.
- Neonatal resuscitation and intensive care were required for Baby B following delivery.
- Multidisciplinary collaboration was critical in achieving successful outcomes in this complex case.

## Abstract

This case report describes the emergent scenario of a 41-year-old primipara at 31.2 weeks of gestation, presenting with abdominal and back pain in the context of a dichorionic diamniotic twin pregnancy complicated by hydrops fetalis. The patient, with a history of hypertension, hyperthyroidism, and a cervical stitch in place, underwent an emergency lower segment cesarean section. The ultrasound revealed an intrauterine left footling in one twin, contributing to the suspected hydrops fetalis. Neonatal complications arose, particularly with Baby B, necessitating immediate resuscitation and intensive care. Successful outcomes were achieved through a well-coordinated multidisciplinary approach involving obstetricians, neonatologists, and anesthesiologists. This case underscores the importance of prompt recognition, timely interventions, and collaborative care in managing complex pregnancies, shedding light on the challenges associated with dichorionic diamniotic twin pregnancies and emphasizing the need for ongoing research to refine perinatal strategies.