Delayed interval delivery after the birth of the first fetus from multiple gestation (description of the serial cases)
Objective. To evaluate the reasonability of delayed labor of pregnancy after preterm labor of the first fetus from the multiple gestation.Dobrohotova Yu.Yu., Makarov O.V., Kuznetsov P.A., Olenev A.S., Ozimkovskaja E.P.
Subjects and methods. We tried to delay delivery of the second/third fetus from the multiple pregnancy, in all cases of preterm labor (22–32 weeks) or late abortion in the absence of contraindications for pregnancy prolongation
Results. In 2011 – 2015 we tried to prolong pregnancy for the second twin in 11 cases (10 twins, 1 triplets).
In 6 cases second twin was born immediately after the first one. In 5 cases delivery of the second twin was delayed for 3–84 days. In the cases of delayed delivery survived 5 of 6 fetuses (second/third fetuses) and only one fetus
of 5 (first fetuses)
Conclusion: delayed delivery of the second twin during preterm labor is an effective method and provides reduction of perinatal mortality.
Keywords
preterm labor
multiple pregnancy
prolonged interval delivery
Supplementary Materials
- Figure 1. Outcomes of multifetal labor with delayed intertwin interval (mass (gram) and the duration of intertwine period (days))
- Figure 2. Survival rate in case of delayed intertwin interval delivery (number of fetuses)
References
1. Demographic Yearbook of Russia – 2014, http://www.gks.ru/bgd/regl/B14_16/Main.htm (in Russian)
2. Blickstein I., Keith L.G., eds. Multiple pregnancy. Epidemiology, gestation and perinatal outcome. London, New York: Taylor & Francis; 2005.
3. Yamasmit W., Chaithongwongwatthana S., Tolosa J.E., Limpongsanurak S., Pereira L., Lumbiganon P. Prophylactic oral betamimetics for reducing preterm birth in women with a twin pregnancy. Cochrane Database Syst. Rev. 2015; (12): CD004733. doi: 10.1002/14651858.CD004733.pub4.
4. Anotayanonth S., Subhedar N.V., Neilson J.P., Harigopal S. Betamimetics for inhibiting preterm labour. Cochrane Database Syst. Rev. 2004; (4): CD004352. doi: 10.1002/14651858.CD004352.pub2.
5. Society for Maternal-Fetal Medicine Publications Committee, with assistance of Vincenzo Berghella. Progesterone and preterm birth prevention: translating clinical trials data into clinical practice. Am. J. Obstet. Gynecol. 2012; 206(5): 376-86. doi: 10.1016/j.ajog.2012.03.010.
6. Roberts D., Dalziel S.R. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst. Rev. 2006; (3): CD004454. doi: 10.1002/14651858.CD004454.pub2.
7. Rafael T.J., Berghella V., Alfirevic Z. Cervical stitch (cerclage) for preventing preterm birth in multiple pregnancy. Cochrane Database Syst. Rev. 2014; (9): CD009166. doi: 10.1002/14651858.CD009166.pub2.
8. Liem S., Schuit E., Hegeman M., Bais J., de Boer K., Bloemenkamp K. et al. Cervical pessaries for prevention of preterm birth in women with a multiple pregnancy (ProTWIN): a multicentre, open-label randomised controlled trial. Lancet. 2013; 382(9901): 1341-9. doi: 10.1016/S0140-6736(13)61408-7.
9. Aydin Y., Celiloglu M. Delayed interval delivery of a second twin after the preterm labor of the first one in twin pregnancies: delayed delivery in twin pregnancies. Case Rep. Obstet. Gynecol. 2012; 2012; 573824. doi: 10.1155/2012/573824.
10. Makarov O.V., Kozlov P.V., Olenev A.S., Ozimkovskaia E.P., Kuznetsov P.A., Klekovkina O.F. Delayed delivery of a second twin after the preterm labor of the first one in bichorial twin pregnancies (case report). Problemy reproduktsii. 2013; 6: 72-4. (in Russian)
11. Zhang J., Johnson C.D., Hoffman M. Cervical cerclage in delayed interval delivery in a multifetal pregnancy: a review of seven case series. Eur. J. Obstet. Gynecol. Reprod. Biol. 2003; 108(2): 126-30.
12. Dobrohotova Yu.E., Kuznetsov P.A., Schukina A.V., Knyazev S.A. A new section for the record «Premature birth». StatusPraesens. Ginekologiya, akusherstvo, besplodnyiy brak. 2015; 2: 119-23. (in Russian)
13. Roman A.S., Fishman S., Fox N., Klauser C., Saltzman D., Rebarber A. Maternal and neonatal outcomes after delayed-interval delivery of multifetal pregnancies. Am. J. Perinatol. 2011; 28(2): 91-6. doi: 10.1055/s-0030-1262513.
Received 06.07.2016
Accepted 02.09.2016
About the Authors
Dobrohotova Yuliya Yeduardovna, PhD, MD, The head of the department of Obstetrics and Gynecology, Medical Faculty, Pirogov Russian National Research Medical University. 117997, Russia, Moscow, Ostrovityanova str. 1. Tel.: +74952374033. E-mail: pr.dobrohotova@mail.ruMakarov Oleg Vasil’evich, PhD, MD, professor of the Department of Obstetrics and Gynecology, Medical Faculty, Pirogov Russian National Research Medical University. 117997, Russia, Moscow, Ostrovityanova str. 1. Tel.: +74952374033. E-mail: profmakarov@mail.ru
Kuznecov Pavel Andreevich, PhD, The head of the consultative department for pregnant women, Perinatal center of City Hospital № 24, associate professor of the Department of Obstetrics and Gynecology, Medical Faculty, Pirogov Russian National Research Medical University.
127287, Russia, Moscow, 4th Vyatskiy per. 39. Tel.: +74956134509. E-mail: poohsmith@mail.ru
Olenev Anton Sergeevich, PhD, The head of the Perinatal center of City Hospital № 24.
127287, Russia, Moscow, 4th Vyatskiy per. 39. Tel.: +74956134509. E-mail: felidis@mail.ru
Ozimkovskaja Elena Petrovna, The head of the Branch № 1 of the Centre of family planning and reproduction.
117303, Russia, Moscow, Azovskaya str. 22. Tel.: +74953183653. E-mail: info@rd10.mosgorzdrav.ru
For citations: Dobrohotova Yu.Yu., Makarov O.V., Kuznetsov P.A., Olenev A.S., Ozimkovskaja E.P. Delayed interval delivery after the birth of the first fetus from multiple gestation (description of the serial cases). Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (2): 86-9. (in Russian)
http://dx.doi.org/10.18565/aig.2017.2.86-9
Similar Articles
