Delayed delivery of multiple gestations: Maternal and neonatal outcomes

OBJECTIVE: The study's aims were to compare neonatal outcomes and to describe maternal complications in patients who underwent delayed delivery of twins or triplets in a preterm gestation. STUDY DESIGN: A retrospective review was performed on 5 sets of twins and 2 sets of triplets. Maternal morbidity was described. Neonatal outcomes were compared in the initial and subsequent delivery groups. RESULTS: The percentage of surviving firstborns was 57%, compared with 78% among latter-born infants. The average gestational age of the initial delivery group was 22.6 weeks (18.8-24.7 weeks); gestational age was 27.4 weeks (19.3-37.9 weeks) for the subsequent group (P < .05), a difference of 32.6 days. The average weight gain was 556.1 g. Serious neonatal complications were less frequent among the subsequently delivered siblings (P < .05), and the mean difference in neonatal hospital stay was 77.3 days, with a range of 62.5 to 139.8 (P < .5). Adverse maternal outcomes were represented by 3 patients with abruptio placentae and 3 patients with intra-amniotic infection, 2 of whom had positive blood culture results. CONCLUSION: On the basis of our experience with 7 multifetal pregnancies, delayed delivery has been demonstrated to increase the likelihood of survival and decrease morbidity among the latter-born siblings. Despite the risk of complications, these data support therapeutic interventions aimed at delayed delivery of subsequent fetuses in cases with the potential for significant morbidity and mortality.