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Federación Mexicana de Ginecología y Obstetricia, A.C.

2019, Number 07

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Ginecol Obstet Mex 2019; 87 (07)

Delayed interval delivery or asynchronous birth of the second twin: a case report with a good outcome neonatal

Hernández-Pérez J, Mir-Ramos E, García-Alarcón FJ, Peinado-Berzosa RM, Aguilón-Leiva JJ, Azón-López E

Language: Spanish
References: 25
Page: 475-482
PDF size: 352.66 Kb.


ABSTRACT

Background: Delayed Interval delivery or asynchronous birth is when a multiple pregnancy`s fetuses are not born simultaneously, and with several day´s difference between their births. This practice´s objective is to increase the second twin´s gestational age and, as such, improve its survival rate.
Clinical Case: A 39 years-old patient with bicorial biamniotic twin pregnancy achieved by in vitro fertilization. At 23 + 2 weeks of pregnancy assisted to Emergency service for vaginal bleeding and abdominal pain. In the speculoscopy a clear amniotic fluid and cervical dilation of 4-5 cm was observed. The cardiotocographic record reported frank uterine dynamics. In the ultrasound, two files are displayed: the first in the syntax presentation in the heartbeat and the second in the transversal with heartbeat. After the birth of the first twin, retraction of the cervix and the disappearance of uterine dynamics were observed. The ecological study showed the amniotic bag intact, without signs of placental detachment or loss of fetal well-being. It was proposed to the couple the possibility of performing the cervical fence and the other part of the second day, which was accepted. It was possible to prolong the gestation of the second year to 77 days, which was born through childbirth, without registering maternal or fetal morbidity.
Conclusions: Delayed Interval delivery is a good practice to increase the survival rate of a retained fetus or retained fetuses. The protocols associated with this type of births are varied. Additional studies are required to establish treatment criteria for this type of births.


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