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Asynchronous multiple birth. A report of five cases

J P Lavery1, R J Austin, D S Schaefer

  • 1Department of Obstetrics, Gynecology and Reproductive Medicine, Michigan State University, East Lansing.

The Journal of Reproductive Medicine
|January 1, 1994
PubMed
Summary
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Extending pregnancy after one fetus is delivered in multiple gestations is feasible. Interventions like tocolytic therapy can prolong pregnancy, improving survival rates for remaining infants.

Area of Science:

  • Perinatology
  • Maternal-Fetal Medicine
  • Neonatology

Background:

  • Multiple gestations present unique challenges in preterm birth.
  • Asynchronous delivery, where one fetus is delivered significantly before others, requires specialized management.
  • Previous literature on prolonging pregnancy after single fetal demise or extreme preterm delivery is limited.

Observation:

  • This study reviewed five clinical cases and existing literature on managing multiple gestations with asynchronous delivery.
  • Pregnancy was successfully extended in all five studied patients following the preterm delivery of one fetus.
  • The review encompassed a total of 52 asynchronously delivered infants from the literature.

Findings:

  • Four of the six remaining infants in the clinical cases survived.

Related Experiment Videos

  • The literature review indicated an 81% survival rate (42 out of 52 infants) for asynchronously delivered infants.
  • Key interventions for extending pregnancy include tocolytic therapy, broad-spectrum antibiotics, and cerclage.

    • Implications:

    • Prolonging pregnancy in cases of asynchronous delivery in multiple gestations is a viable strategy.
    • Successful outcomes depend on careful patient selection, informed consent, and aggressive medical management.
    • This approach offers a potential pathway to improve neonatal outcomes in complex multiple gestations.