Delayed-interval Delivery in Multiple Pregnancies: Short- and Long-term Outcome

Abstract Purpose Multiple pregnancies are at higher risk of preterm birth due to premature labor, cervical insufficiency, or premature rupture of membranes. However, both children do not necessarily have to be born and exposed to the morbidity of prematurity depending on the age of gestation. One option is a delayed-interval delivery with reduction of morbidity and mortality for the second twin, considering maternal morbidity. Methods Retrospective study of delayed-interval deliveries in multiple pregnancies with evaluation of short-and long-term outcome from 2003 to 2020 at the Women’s and Children’s Hospital of the University Hospital . Results In 17 cases, the delivery of the second twin could be prolonged, on average for 36 days. Pregnancies with delivery of the first twin before 22 weeks of gestation had a longer prolongation than pregnancies with delivery of the first twin after 22 weeks (53 vs. 22 days). In cases where a cerclage was placed, on average a longer prolongation interval (45 vs. 19 days) was observed. The short- and long-term follow-up of the second twin is comparable to the usual complication rate of premature birth. Conclusion Multiple pregnancies endangered by premature birth can be successfully prolonged for the second twin without serious maternal morbidity. If the first twin is born before 22 weeks of gestation and a cerclage is performed afterwards, a longer prolongation interval appears.