Resolution of Preeclampsia After Single Selective Termination in Twins: A Case Series and Literature Review

Abstract

Preeclampsia significantly contributes to maternal and perinatal morbidity and mortality, with twin pregnancies increasing this risk. Severe preeclampsia often requires pregnancy termination to protect maternal health. We report two cases of IVF-conceived twin pregnancies complicated by early preeclampsia. The first case involved a 34 year-old woman, gravida-2, abortion-1 at 21 weeks gestation with monochorionic twins, blood pressure of 150/80 mmHg, and proteinuria of 1600 mg. She underwent radiofrequency ablation of one twin at 22 weeks and delivered a healthy infant at 37 weeks. The second case involved a 34 year-old woman diagnosed with preeclampsia at 22 weeks, who experienced severe placental abruption in the third trimester, resulting in preterm delivery and a neonate admitted to the NICU. Selective fetal reduction may be a viable therapeutic option in managing twin pregnancies complicated by early severe preeclampsia. Such interventions should be performed with full maternal consent and a strong desire to continue the pregnancy.