An analysis of the maternal and infant outcomes in the delayed interval delivery of twins.

Objective: To investigate the treatment methods used for the delayed interval delivery of twins and to evaluate the maternal and infant outcomes. Materials and methods: The clinical data of 5 patients that underwent delayed interval delivery of twins at Fujian Maternal and Child Health Hospital from 2014 to 2018 were analyzed. The gestational ages at delivery, obstetrical management, the interval between deliveries, and the maternal and child outcomes were analyzed. Results: The average gestational age at delivery of the first child was 23(+3) weeks (range: 20(+1)-30(+2) weeks). All 5 mothers underwent high ligation of the umbilical cord and received prophylactic antibiotic treatment. Tocolytics were administered to 3 patients, 1 of which had previously undergone cervical cerclage placement. No tocolytics were administered to the remaining 2 patients. The average delayed delivery time was 15 days (range: 3-31 days). The second child was delivered at an average gestational age of 25(+5) weeks (range: 20(+4)-31(+3) weeks). The average birth weight of the second twin was 957 g (range: 360-1930 g). Three of the patients delivered vaginally, 1 delivered via a cesarean section, and 1 required a breech extraction. Of these deliveries, there were 3 neonatal survivals. Pathogens were detected in the cervical secretion cultures in all cases. Two patients had grade 2 placental abruption, 5 had an intrauterine infection, 1 developed sepsis, 1 developed postpartum hemorrhage, and 5 showed a placenta adherence. Conclusion: The delayed interval delivery of twins is a unique treatment for patients experiencing a twin pregnancy. Successful performance of this method can improve the survival rates for the second twin and improve prognosis. However, careful attention is required when performing this treatment to prevent and treat possible complications that may arise during the procedure. (C) 2020 Taiwan Association of Obstetrics & Gynecology. Publishing services by Elsevier B.V.