Kalchbrenner M A, Weisenborn E J, Chyu J K, Kaufman H K, Losure T A
Maternal-Fetal Medicine Department, Rockford Regional Perinatal Center, University of Illinois, Rockford, IL 61103, USA.
Am J Obstet Gynecol. 1998 Nov;179(5):1145-9. doi: 10.1016/s0002-9378(98)70122-x.
The study's aims were to compare neonatal outcomes and to describe maternal complications in patients who underwent delayed delivery of twins or triplets in a preterm gestation.
A retrospective review was performed on 5 sets of twins and 2 sets of triplets. Maternal morbidity was described. Neonatal outcomes were compared in the initial and subsequent delivery groups.
The percentage of surviving firstborns was 57%, compared with 78% among latter-born infants. The average gestational age of the initial delivery group was 22.6 weeks (18.9-24.7 weeks); gestational age was 27.4 weeks (19.3-37.9 weeks) for the subsequent group (P <.05), a difference of 32.6 days. The average weight gain was 556.1 g. Serious neonatal complications were less frequent among the subsequently delivered siblings (P <.05), and the mean difference in neonatal hospital stay was 77.3 days, with a range of 62.5 to 139.8 (P <.5). Adverse maternal outcomes were represented by 3 patients with abruptio placentae and 3 patients with intra-amniotic infection, 2 of whom had positive blood culture results.
On the basis of our experience with 7 multifetal pregnancies, delayed delivery has been demonstrated to increase the likelihood of survival and decrease morbidity among the latter-born siblings. Despite the risk of complications, these data support therapeutic interventions aimed at delayed delivery of subsequent fetuses in cases with the potential for significant morbidity and mortality.
