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CC BY-NC-ND 4.0 · AJP Rep 2024; 14(02): e156-e161
DOI: 10.1055/s-0044-1787112
Case Report

Delayed-Interval Delivery in Multiple Pregnancy: A Single-Center Experience of Five Cases

Roaa Hassan Gadeer
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology and Newborn Care, The Ottawa Hospital, Ontario, Canada
,
Ahlam Alhinai
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology and Newborn Care, The Ottawa Hospital, Ontario, Canada
,
Karen Fung-Kee-Fung
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology and Newborn Care, The Ottawa Hospital, Ontario, Canada
,
Ana Werlang
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology and Newborn Care, The Ottawa Hospital, Ontario, Canada
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Abstract

Objectives To describe the obstetric management and perinatal outcomes in multiple pregnancies with delayed-interval delivery (DID) of the cotwin in a tertiary hospital.

Methods This is a retrospective chart review of all cases of DID between December 2021 and 2022 at The Ottawa Hospital. Five cases of DID were identified and reviewed to obtain information on obstetric management and maternal–neonatal outcomes. We included eligible twins and triplets. No multiples were excluded. We obtained ethics approval for this case series.

Results Four sets of dichorionic diamniotic twins and one trichorionic triamniotic triplet were included. Our patients were admitted between 173/7 and 215/7 weeks of gestation. We achieved an interval delivery range between 1 and 36 days. Four out of six multiples did not survive in DID. The two surviving newborns were born at 230/7 and 232/7, stayed in the neonatal intensive care unit (NICU) for 111 and 131 days, discharged with a weight of 3,594 and 2,743 g, respectively. All DID cases were delivered spontaneously except for two patients that required augmentation due to maternal sepsis.

Conclusion Despite the high risk of maternal, fetal, and neonatal morbidity and mortality, if delivery of the first twin occurs before 20 gestational weeks, DID could be considered in selected cases to improve outcomes for the cotwin.

Keywords

multiple - preterm birth - multiple pregnancy - premature - infant


Publication History

Received: 16 February 2024

Accepted: 27 March 2024

Article published online:
23 May 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 American College of Obstetricians and Gynecologists. Multifetal gestations: twin, triplet, and higher-order multifetal pregnancies: ACOG Practice Bulletin, Number 231. Obstet Gynecol 2021; 137 (06) e145-e162
    CrossrefPubMedGoogle Scholar
  • 2 Benito Vielba M, De Bonrostro Torralba C, Pallares Arnal V, Herrero Serrano R, Tejero Cabrejas EL, Campillos Maza JM. Delayed-interval delivery in twin pregnancies: report of three cases and literature review. J Matern Fetal Neonatal Med 2019; 32 (02) 351-355
    CrossrefPubMedGoogle Scholar
  • 3 Kolben T, Fischer D, Ruehl I. et al. Delayed interval delivery in multiple gestations: the Munich experience. Arch Gynecol Obstet 2019; 299 (02) 339-344
    CrossrefPubMedGoogle Scholar
  • 4 Caughey AB. Creasy and Resnik's maternal-fetal medicine: principles and practice. JAMA 2009; 302: 2154-2158
    CrossrefPubMedGoogle Scholar
  • 5 Hüner B, Essers J, Schiefele L. et al. Obstetric and fetal short- and long-term outcomes of delayed-interval delivery in multiple pregnancies. J Gynecol Obstet Hum Reprod 2022; 51 (10) 102486
    CrossrefPubMedGoogle Scholar
  • 6 Cheung KW, Seto MTY, Wang W, Lai CWS, Kilby MD, Ng EHY. Effect of delayed interval delivery of remaining fetus(es) in multiple pregnancies on survival: a systematic review and meta-analysis. Am J Obstet Gynecol 2020; 222 (04) 306-319.e18
    CrossrefPubMedGoogle Scholar
  • 7 Roman AS, Fishman S, Fox N, Klauser C, Saltzman D, Rebarber A. Maternal and neonatal outcomes after delayed-interval delivery of multifetal pregnancies. Am J Perinatol 2011; 28 (02) 91-96
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Louchet M, Dussaux C, Luton D, Goffinet F, Bounan S, Mandelbrot L. Delayed-interval delivery of twins in 13 pregnancies. J Gynecol Obstet Hum Reprod 2020; 49 (02) 101660
    CrossrefPubMedGoogle Scholar
  • 9 Reinhard J, Reichenbach L, Ernst T. et al. Delayed interval delivery in twin and triplet pregnancies: 6 years of experience in one perinatal center. J Perinat Med 2012; 40 (05) 551-555
    CrossrefPubMedGoogle Scholar
  • 10 Zhang J, Johnson CD, Hoffman M. Cervical cerclage in delayed interval delivery in a multifetal pregnancy: a review of seven case series. Eur J Obstet Gynecol Reprod Biol 2003; 108 (02) 126-130
    CrossrefPubMedGoogle Scholar
  • 11 Cristinelli S, Fresson J, André M, Monnier-Barbarino P. Management of delayed-interval delivery in multiple gestations. Fetal Diagn Ther 2005; 20 (04) 285-290
    CrossrefPubMedGoogle Scholar