A case report of preterm homebirth in twin pregnancy

Abstract

The aim: To present a unique event in prehospital medicine, which was a home birth in extreme prematurity. At the same time, we try to present ways of dealing with such an unusual condition in emergency medicine. Material and methods: The basis for the considerations was a case taken from a Pediatric Teaching Clinical Hospital University Clinical Center of the Medical University of Warsaw. In this case, we report a premature birth in a twin pregnancy that occurred in home, so it was out-of-hospital environment. The twin infants were at home born at 22 weeks and 6/7 days of gestational age. After initial resuscitation at the scene, the patients were transported to an Emergency Department in the hospital of the highest referral level. Conclusions: Prehospital medicine is not prepared to handle extremely preterm birth. The unique clinical needs of infants born at ≤23 weeks are noticed and should be distinguished from those of more mature infants. Only a few high-quality sources of clinical evidence exist to guide care for this population, which requires specialized attention. The problem of prehospital delivery in extreme prematurity is almost absent in the medical literature. Additional investigation is required to enhance our comprehension of optimal care practices for infants born during these early gestational stages.