The objective of this study is to evaluate neonatal and maternal outcomes of multiple
gestations undergoing delayed-interval delivery at a single institution. A 10-year
retrospective review of medical records of patients followed by a Maternal-Fetal Medicine
practice in a university-based setting was performed. Patients met criteria for inclusion
if a single fetus was delivered spontaneously between 16 and 28 weeks of gestation
and a planned attempt was made to prolong the gestation for the remaining fetus(es).
Nineteen pregnancies met criteria for inclusion. The median gestational age at delivery
of the first fetus was 202/7 weeks and the last fetus was 251/7 weeks. The median latency was 16 days (range 0 to 152 days). Three patients (15.8%)
delivered within 24 hours. There was a 15.8% survival rate for the firstborn fetus
and a 53.8% survival rate for all retained fetuses (p = 0.01). There was a 31.6% incidence of serious maternal morbidity related to the
procedure. One patient required a postpartum hysterectomy due to massive hemorrhage
and uterine atony. Delayed-interval delivery is associated with a higher neonatal
survival rate when retained fetuses are compared with firstborn fetuses. However,
the procedure is associated with a significant risk of serious maternal morbidity.
Multifetal pregnancy - delayed-interval delivery - neonatal morbidity - maternal morbidity
