Delayed-Interval Delivery in Dichorionic Twin Pregnancies: A Single-Center Experience

Area of Science:

• Maternal-Fetal Medicine
• Perinatology
• Obstetrics

Background:

• Preterm delivery is a major complication in multiple gestations, leading to high perinatal mortality.
• In multiple gestations, delivery of the first fetus is often inevitable once preterm labor begins.
• Delaying delivery of the second fetus can significantly improve perinatal outcomes.

Purpose of the Study:

• To report on the successful management of delayed-interval delivery in dichorionic diamniotic twin pregnancies.
• To highlight the potential for improved outcomes in the second twin when pregnancy is prolonged after the demise of the first.

Main Methods:

• Case report of two dichorionic diamniotic twin pregnancies presenting with preterm labor.
• Management involved leaving the second twin in utero after the abortion of the first fetus.
• Antibiotics and tocolytic therapy (after 24 weeks) were administered to prolong the pregnancy.

Main Results:

• Pregnancy was prolonged by 64 days in one case and 16 days in the other.
• Uterine contractions ceased after the abortion of the first fetus in both cases.
• This approach demonstrated the feasibility of delaying delivery for the second twin.

Conclusions:

• No established protocol exists for delayed-interval delivery in such cases.
• Successful management in a tertiary perinatal center can lead to excellent outcomes for the second twin.
• This strategy offers a potential lifesaving option for the second fetus in specific twin pregnancy complications.