Jazayeri Allahyar, Mamlok Vivian, Dorsett Mark M, Porter Kathy B
Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX 79430, USA.
J Reprod Med. 2002 Feb;47(2):167-9.
Prolonged-interval delivery between twins can improve neonatal outcome and, under careful monitoring, poses minimal maternal risk.
A 27-year-old, nulliparous woman conceived after in vitro fertilization and was found to have diamniotic-dichorionic twins. At 17 weeks she presented with premature preterm rupture of the membranes of twin A. She was offered delivery or expectant management. She chose expectant management and was discharged. At 18 weeks she delivered twin A and decided to expectantly manage the second twin. Amniocentesis was performed to evaluate for intraamniotic infections. There was no evidence of them, and a McDonald cerclage was placed. At 32 weeks, spontaneous rupture of the membranes occurred for twin B. The patient delivered vaginally a male infant (2,070 g) who did not need mechanical ventilation and was discharged from neonatal intensive care on the 7th day of life, with no complications.
Expectant management of a second twin after delivery of the first in selected patients can improve neonatal outcome.
双胎之间延长间隔分娩可改善新生儿结局，并且在严密监测下，对母亲的风险最小。
一名27岁未生育的女性，通过体外受精受孕，被发现怀有双羊膜囊双绒毛膜双胎。孕17周时，双胎A出现胎膜早破。她面临分娩或期待治疗的选择。她选择了期待治疗并出院。孕18周时，她分娩了双胎A，并决定对第二个胎儿继续进行期待治疗。进行了羊膜腔穿刺术以评估羊膜腔内感染情况。未发现感染迹象，遂放置了麦克唐纳宫颈环扎术。孕32周时，双胎B发生胎膜自然破裂。患者经阴道分娩一名男婴（体重2070克），该男婴无需机械通气，出生后第7天从新生儿重症监护病房出院，无并发症。
在部分患者中，第一个胎儿分娩后对第二个胎儿进行期待治疗可改善新生儿结局。
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