Delayed second twin delivery: benefits and risks
Mohamed Farghali1, Ibrahim Abdelazim1, Khaled Abdelrazek1
1a Department of Obstetrics and Gynecology , Faculty of Medicine, Ain Shams University , Cairo , Egypt.
Summary
Delayed second twin delivery significantly improves gestational age, birth weight, and survival rates for the second twin. This management strategy offers considerable benefits for prolonged twin pregnancies.
Area of Science:
- Maternal-Fetal Medicine
- Perinatology
- Obstetrics
Background:
- Reports on delayed second twin delivery show varied outcomes and survival rates.
- No randomized controlled trials (RCTs) exist for this management approach.
- This study evaluates a specific protocol for delayed second twin delivery.
Purpose of the Study:
- To assess the outcomes, risks, and benefits of delayed second twin delivery.
- To evaluate the management strategy at Sabah Maternity Hospital.
- To provide evidence for the safety and efficacy of prolonged twin gestation.
Main Methods:
- Included 47 twin pregnancies with preterm labor of the first twin (20-30 weeks).
- Obtained informed consent regarding risks of intrauterine environment and benefits of prolonged gestation.
- Employed conservative management with hospitalization and regular monitoring for infections, coagulopathy, and fetal well-being.
Main Results:
- Significant increase in gestational age (34.3 ± 2.5 weeks) and birth weight (1472 ± 61.5g) for the second twin.
- High survival rate for the second twin (85.1%).
- Higher rate of cesarean delivery for the second twin (23.4%) compared to the first (0%).
Conclusions:
- Delayed second twin delivery significantly enhances gestational age, birth weight, and survival rate.
- The studied management protocol demonstrates positive outcomes for the second twin.
- This approach offers a viable option for managing specific twin pregnancy scenarios.
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