Delayed-interval delivery of twins in 13 pregnancies.


Journal

Journal of gynecology obstetrics and human reproduction
ISSN: 2468-7847
Titre abrégé: J Gynecol Obstet Hum Reprod
Pays: France
ID NLM: 101701588

Informations de publication

Date de publication:
Feb 2020
Historique:
received: 01 08 2019
revised: 20 10 2019
accepted: 27 11 2019
pubmed: 7 12 2019
medline: 8 1 2021
entrez: 7 12 2019
Statut: ppublish

Résumé

Delayed interval delivery is a rare practice aiming at prolonging gestation for the second twin in case of pre-viable birth of twin one. Our objective was to identify factors related to successful delayed delivery of the second twin, among cases in which the interval after delivery of the first twin was above 24h. A descriptive, retrospective and multicenter study of all delayed interval deliveries in dichorionic twins in 4 perinatal centers in Paris over a 14-year period. In 13 cases of delayed interval delivery, delivery of twin 1 was at a median of 18 weeks' gestation (range 14WG+2days to 24WG), and none survived. Delivery of the second twin occurred at a median of 25 weeks' gestation +3 days, 51 days after twin 1 (range 13-138 days). Seven of the 13s twins (54 %) survived. There were 5 cases of chorioamnionitis and 1 case of maternal disseminated intravascular coagulation. Poor outcome was not significantly associated with the gestational age, presentation for PPROM or inflammatory markers (C-reactive protein and white blood cell count) at the time of delivery of twin 1. Delayed-interval delivery of the second twin may prolong pregnancy and lead the second twin child to a viable term of birth; but carries a risk of maternal complications.

Sections du résumé

BACKGROUND BACKGROUND
Delayed interval delivery is a rare practice aiming at prolonging gestation for the second twin in case of pre-viable birth of twin one. Our objective was to identify factors related to successful delayed delivery of the second twin, among cases in which the interval after delivery of the first twin was above 24h.
METHOD METHODS
A descriptive, retrospective and multicenter study of all delayed interval deliveries in dichorionic twins in 4 perinatal centers in Paris over a 14-year period.
RESULTS RESULTS
In 13 cases of delayed interval delivery, delivery of twin 1 was at a median of 18 weeks' gestation (range 14WG+2days to 24WG), and none survived. Delivery of the second twin occurred at a median of 25 weeks' gestation +3 days, 51 days after twin 1 (range 13-138 days). Seven of the 13s twins (54 %) survived. There were 5 cases of chorioamnionitis and 1 case of maternal disseminated intravascular coagulation. Poor outcome was not significantly associated with the gestational age, presentation for PPROM or inflammatory markers (C-reactive protein and white blood cell count) at the time of delivery of twin 1.
CONCLUSION CONCLUSIONS
Delayed-interval delivery of the second twin may prolong pregnancy and lead the second twin child to a viable term of birth; but carries a risk of maternal complications.

Identifiants

pubmed: 31809959
pii: S2468-7847(19)30693-2
doi: 10.1016/j.jogoh.2019.101660
pii:
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

101660

Informations de copyright

Copyright © 2019. Published by Elsevier Masson SAS.

Auteurs

Margaux Louchet (M)

Assistance Publique-Hôpitaux de Paris, Hôpital Louis Mourier, Department of Obstetrics and Gynecology, Colombes, France; Université de Paris, Paris, France; DHU Risques et Grossesse, Paris, France.

Chloé Dussaux (C)

Assistance Publique-Hôpitaux de Paris, Hôpital Louis Mourier, Department of Obstetrics and Gynecology, Colombes, France; Université de Paris, Paris, France; DHU Risques et Grossesse, Paris, France.

Dominique Luton (D)

Université de Paris, Paris, France; DHU Risques et Grossesse, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, Department of Obstetrics and Gynecology, Paris, France.

François Goffinet (F)

Université de Paris, Paris, France; DHU Risques et Grossesse, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Cochin-Port Royal, Department of Obstetrics and Gynecology, Paris, France; Inserm U1153 Epopé, Paris, France.

Stéphane Bounan (S)

Department of Obstetrics and Gynecology, Hôpital Delafontaine, Saint-Denis, France.

Laurent Mandelbrot (L)

Assistance Publique-Hôpitaux de Paris, Hôpital Louis Mourier, Department of Obstetrics and Gynecology, Colombes, France; Université de Paris, Paris, France; DHU Risques et Grossesse, Paris, France; Inserm IAME U1137, F-75018, Paris, France. Electronic address: laurent.mandelbrot@aphp.fr.

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Classifications MeSH