Prolongation of a Preterm Pregnancy Complicated by Death of a Single Twin in Utero and Disseminated Intravascular Coagulation

THE association of intrauterine fetal death and maternal disseminated intravascular coagulation is well established and generally referred to as the "fetal-death syndrome."1 2 3 4 5 6 7 Although most cases of this syndrome have been reported in the setting of a singleton gestation, it can occur after the death of one of the members of a multiple gestation.8 The occurrence of the fetal-death syndrome in a preterm multiple gestation poses important therapeutic dilemmas. Termination of the pregnancy for maternal indications would result in the birth of a premature infant; prolongation of the pregnancy could result in life-threatening maternal hemostatic failure. Although the incidence of this . . .