Abstract
Objectives To describe the obstetric management and perinatal outcomes in multiple pregnancies
with delayed-interval delivery (DID) of the cotwin in a tertiary hospital.
Methods This is a retrospective chart review of all cases of DID between December 2021 and
2022 at The Ottawa Hospital. Five cases of DID were identified and reviewed to obtain
information on obstetric management and maternal–neonatal outcomes. We included eligible
twins and triplets. No multiples were excluded. We obtained ethics approval for this
case series.
Results Four sets of dichorionic diamniotic twins and one trichorionic triamniotic triplet
were included. Our patients were admitted between 173/7 and 215/7 weeks of gestation. We achieved an interval delivery range between 1 and 36 days.
Four out of six multiples did not survive in DID. The two surviving newborns were
born at 230/7 and 232/7, stayed in the neonatal intensive care unit (NICU) for 111 and 131 days, discharged
with a weight of 3,594 and 2,743 g, respectively. All DID cases were delivered spontaneously
except for two patients that required augmentation due to maternal sepsis.
Conclusion Despite the high risk of maternal, fetal, and neonatal morbidity and mortality, if
delivery of the first twin occurs before 20 gestational weeks, DID could be considered
in selected cases to improve outcomes for the cotwin.
Keywords
multiple - preterm birth - multiple pregnancy - premature - infant
