Delayed Interval Delivery (DID) in twin pregnancy: A rare case report (2 cases)

Background: Multifetal gestations are often complicated by spontaneous preterm birth. When this occurs before or proximate to the lower gestational age limit of ex utero survival, the neonates are at high risk for prolonged hospitalization, serious morbidity, and/or mortality. It is a rare practice aiming at prolonging gestation for second twin in case of pre viable birth of twin one [1]. Our objective was to identify factors related to successful DID of the second twin, among cases in which the interval after delivery of the first twin was above 24 h.Results: We had total 2 cases of delayed delivery of twins. First case, Mrs. M, admitted at 27+6 weeks with PPROM, expelled twin 1 after 12 hrs of admission. Due to labour inertia, DID planned, delivered twin 2, after 3 days latency period. Twin 1 had neonatal death, twin 2 survived. In second case, Mrs.A, admitted with PPROM at 26+5 weeks, delivered twin 1 after 6 hrs of admission. DID planned, placenta of twin 1 left in situ. Steroids and tocolysis, prophylactic antibiotics given. Emergency LSCS done and delivered twin 2 in view of breech in labour, after 29 days of twin 1 delivery. In both cases twin 1 had NND. In first case, baby delivered with weight of 1.1kg, with 60 days of NICU and discharged with weight of 2.2 kg. In second case baby delivered with weight of 1.1kg, with 45 days of NICU (Because of more exposure to intra uterine environment) and discharged with weight of 2.4 kg. Conclusion: DID of the second twin may prolong pregnancy and lead to a viable term of birth. There is a need to standardize the management of DID through additional research.