American Journal of Obstetrics and Gynecology
ResearchObstetricsDelayed-interval delivery in twin and triplet pregnancies: 17 years of experience in 1 perinatal center
Section snippets
Materials and Methods
From 1991 to 2007, data on twin and triplet pregnancies were collected in our high-risk center. Cases in which the first twin or triplet was born vaginally between 16 and 31 weeks and the delivery of the remaining multiples could be postponed form the definite study group.
All patients were managed by the 2 authors. The intention to delay delivery was to not only reach viability but also strive for improved outcome for the remaining fetus(es) with the possibility of corticosteroid
Results
Using the described protocol, data on 93 twin and 34 triplet pregnancies complicated by threatening early delivery of the first fetus between 16 and 31 gestational weeks were consecutively collected between 1991 and 2007. They were characterized by progressive dilatation and contractions. After admission, 45 twin pregnancies and 8 triplet pregnancies were excluded from further analysis, because there were contraindications to delay pregnancy because of signs of fetal distress, signs of
Comment
This study evaluated the neonatal outcome and maternal risks for twin and triplet pregnancies and for either immature (< 25 weeks) or early premature (25-31 weeks) delivery of first multiples. A standard protocol was established prior to the recruitment and was followed by the 2 authors throughout the observation period.5 This is the first prospective and largest 1-center series that enables the determination of the success rate of attempted delayed-interval delivery balancing the potential
Acknowledgment
In this article, several times we cited Dr Elizabeth Bryan, the wife of Ronald Higgins. Dr Bryan died in February 2008, as we started to write this article. Her enthusiastic lectures, careful studies, and several books, 1 written together with her husband, helped us to understand the joys and sorrows of all our patients with multiple gestations and mainly the frequently ambiguous situation within delay interval delivery. Her work for the Multiple Birth Foundation, the World Twin Research Group,
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Obstetric and fetal short- and long-term outcomes of delayed-interval delivery in multiple pregnancies
2022, Journal of Gynecology Obstetrics and Human ReproductionCitation Excerpt :A larger cases series with 50 cases observed similar results. 11 cases developed a chorioamnionitis and in 5 cases a higher blood loss occurred [16]. In a systematic review serious maternal morbidity was reported in 39% of pregnancies after delayed-interval deliveries [7].
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2020, American Journal of Obstetrics and GynecologyAn analysis of the maternal and infant outcomes in the delayed interval delivery of twins
2020, Taiwanese Journal of Obstetrics and GynecologyCitation Excerpt :Some scholars consider that the second child may have serious nervous system damage due to diminished placental perfusion [10]. However, other scholars consider that the second child can essentially achieve a good outcome [7]. In DIDT, the lower limit of the gestational age of the first aborted child is 20–22 weeks.
Effect of delayed interval delivery of remaining fetus(es) in multiple pregnancies on survival: a systematic review and meta-analysis
2020, American Journal of Obstetrics and GynecologyCitation Excerpt :Mean delayed interval was 29.0 days (n = 127 pregnancies, ranging from 1 to 153 days). Five studies had a standard or uniform protocol for DID.9,11,13,18,23 Of 170 pregnancies with details of DID, antibiotic, tocolysis, and cerclage were used in 100% (170 of 170), 99.4% (168 of 170), and 47% (80 of 170), respectively.
Cite this article as: Arabin B, van Eyck J. Delayed-interval delivery in twin and triplet pregnancies: 17 years of experience in 1 perinatal center. Am J Obstet Gynecol 2009;200:154.e1-154.e8.