Baltus Tanja, Martin Maria Luisa
Department of Obstetrics and Gynaecology, Blacktown Hospital, New South Wales, 18 Blacktown Road, Blacktown, NSW 2148, Australia.
Case Rep Womens Health. 2018 Dec 18;21:e00093. doi: 10.1016/j.crwh.2018.e00093. eCollection 2019 Jan.
Delayed-interval delivery in twin pregnancy is a rare occurrence. It is sometimes performed in twin pregnancies when the first twin is born at the limit of viabililty, to improve outcome for the second twin. It has been suggested that monochorionicity is a contraindication to delayed-interval delivery in multifetal pregnancy. The literature describes only a dozen cases over the last 20 years and only a handful of these reports specify success. We describe a case of a successful delayed-interval delivery of monochorionic diamniotic twins following prelabour rupture of membranes at 20 weeks of gestation. The first twin was previable, delivered at 23 weeks and 2 days of gestation, but the second twin was delivered at 24 weeks and 1 day of gestation and survived. Practitioners could consider delayed-interval delivery in monochorionic diamniotic twin pregnancy in a closely monitored environment if the first twin is born peri-viable, to obtain an improved outcome for the remaining fetus.
双胎妊娠中的延迟间隔分娩很少见。当第一个胎儿在可存活极限出生时，有时会在双胎妊娠中进行延迟间隔分娩，以改善第二个胎儿的结局。有人提出单绒毛膜性是多胎妊娠中延迟间隔分娩的禁忌证。文献记载在过去20年中仅有十几例，且这些报告中只有少数明确表示成功。我们描述了一例妊娠20周胎膜早破后成功进行单绒毛膜双羊膜囊双胎延迟间隔分娩的病例。第一个胎儿不可存活，于妊娠23周2天出生，但第二个胎儿于妊娠24周1天出生并存活。如果第一个胎儿接近可存活时出生，在密切监测的环境下，从业者可考虑对单绒毛膜双羊膜囊双胎妊娠进行延迟间隔分娩，以改善剩余胎儿的结局。
