Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-Maternal Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria.
Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Intensive Care Medicine and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria.
BMJ Case Rep. 2023 Sep 15;16(9):e254705. doi: 10.1136/bcr-2023-254705.
Preterm birth is a significant cause of perinatal morbidity and mortality, especially in multiple pregnancies. Delayed interval delivery can prolong pregnancy for the remaining fetus(es) in an imminent stillbirth or extremely preterm birth of the first fetus, improving the lastborn's outcomes. We present a case of delayed interval delivery of a triplet pregnancy following preterm prelabour rupture of membranes and progressive cervical insufficiency. Following vaginal delivery of the first fetus at 24+1 gestational weeks, the patient received antibiotics and tocolysis. Cerclage was not conducted as the mother had a vaginal infection. A 15-day delivery interval for the second and third fetuses was achieved. The firstborn required mechanical ventilation and inotropic support, while the others only required continuous positive airway pressure. There is no consensus on the best way to perform delayed interval delivery. We achieved a complications-free interval of 15 days with conservative management in a triplet pregnancy.
早产是围产期发病率和死亡率的重要原因，特别是在多胎妊娠中。延迟间隔分娩可以延长第一个胎儿即将发生的死产或极早产的剩余胎儿的妊娠时间，从而改善最后出生的胎儿的结局。我们报告了一例三胞胎妊娠在胎膜早破和宫颈进行性不全的情况下延迟间隔分娩的病例。在 24+1 孕周经阴道分娩第一胎后，患者接受了抗生素和宫缩抑制剂治疗。由于母亲有阴道感染，因此未行宫颈环扎术。第二和第三胎儿的分娩间隔为 15 天。头胎需要机械通气和正性肌力支持，而其他胎儿仅需要持续气道正压通气。目前对于如何进行延迟间隔分娩尚无共识。我们通过保守治疗在三胞胎妊娠中实现了无并发症的 15 天间隔。
