Yeungnam Univ J Med.  2018 Jun;35(1):135-139. 10.12701/yujm.2018.35.1.135.

Successful delayed-interval delivery performed 128 days after the vaginal delivery of the first fetus in a twin pregnancy

• Koo YJ

• KMID: 2415748
• DOI: http://doi.org/10.12701/yujm.2018.35.1.135

Abstract

There has been a significant increase in the number of multiple pregnancies that are associated with a high risk of preterm delivery among Korean women. However, to date, delayed-interval delivery in women with multiple pregnancy is rare. We report a case of delayed-interval delivery performed 128 days after the vaginal delivery of the first fetus in a dichorionic diamniotic twin pregnancy. The patient presented with vaginal leakage of amniotic fluid at 16 weeks of gestation and was diagnosed with a preterm premature rupture of membranes. Three days later, the first twin was delivered, but the neonate died soon after. The second twin remained in utero, and we decided to retain the fetus in utero to reduce the morbidity and mortality associated with a preterm birth. The patient was managed with antibiotics and tocolytics. Cervical cerclage was not performed. The second twin was delivered vaginally at 34 weeks and 5 days of gestation, 128 days after the delivery of the first-born fetus. This neonate was healthy and showed normal development during the 1-year follow-up period. Based on our experience with this case, we propose that delayed-interval delivery may improve perinatal survival and decrease morbidity in the second neonate in highly selected cases.

Keyword

Delayed-interval delivery; Multiple pregnancy; Twin pregnancy; Premature birth

MeSH Terms

Amniotic Fluid
Anti-Bacterial Agents
Cerclage, Cervical
Female
Fetus*
Follow-Up Studies
Humans
Infant, Newborn
Membranes
Mortality
Pregnancy
Pregnancy, Multiple
Pregnancy, Twin*
Premature Birth
Rupture
Tocolytic Agents
Twins*
Anti-Bacterial Agents
Tocolytic Agents

Figure

• 

  Fig. 1. Transvaginal ultrasonographic examination shows images of the cervix. The functional length of the cervix was observed to be 2.7 cm with Y-shape funneling at the time of the patient’s visit to the emergency room at 16 weeks of gestation (A). The cervical length was observed to have normalized to 3.2 cm without funneling 8 days after the delivery of the first-born fetus (B).

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