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Delayed interval delivery in multiple gestations: the Munich experience

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

To evaluate delayed interval deliveries in multiple gestations in regard of delayed interval and neonatal survival and to provide a protocol.

Methods

Data of multiple pregnancies with delayed interval delivery at a tertiary maternity unit between 2002 and 2017 were collected. Contraindications for evaluation of a delay of the delivery of the remaining child were: severe maternal blood loss, poor maternal general condition, preeclampsia, placental abruption, fetal distress, serious congenital malformations of the remaining child, chorioamnionitis, and premature rupture of membranes of the second fetus. A total of 14 cases was included in this retrospective monocentric analysis.

Results

The cohort comprised nine twin and five triplet pregnancies. Mean gestational age at delivery of the first fetus was 21 + 6 and 26 + 0 of the retained fetus, respectively. The earliest delivery of the first fetus was at 15 + 2 weeks. The mean interval of the delay was 29.3 days (2–82 days). Mortality of the first fetuses was 53.3%, while it was 17.6% for the retained fetuses. Maternal outcome was good in general: two cases of major blood loss occurred with the necessity of a blood transfusion.

Conclusion

Delayed interval delivery is a reasonable approach in cases of an imminent preterm birth in multiple gestations which can be performed with a good fetal outcome and limited maternal risks. The situation when this procedure may be an option always comes unexpected. Therefore, the team of perinatologists should keep it in mind as one potential therapeutic approach. In addition, a standard protocol for the procedure should be established in the perinatal center.

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Acknowledgements

The authors thank M Etheridge, M.A. Interpreting and Translating, for professional language editing (unsalaried). This manuscript is part of the dissertation of D. Fischer.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany

    Thomas Kolben, Daniel Fischer, Marie Franz, Anna Hester, Theresa Maria Kolben, Charlotte Deppe, Maria Delius, Klaus Friese, Sven Mahner, Uwe Hasbargen & Christoph Hübener

  2. Department of Obstetrics and Gynecology, Rotkreuzklinikum Munich, Munich, Germany

    Ina Ruehl

Authors
  1. Thomas Kolben
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  2. Daniel Fischer
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  3. Ina Ruehl
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  4. Marie Franz
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  5. Anna Hester
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  6. Theresa Maria Kolben
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  7. Charlotte Deppe
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  8. Maria Delius
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  9. Klaus Friese
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  10. Sven Mahner
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  11. Uwe Hasbargen
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  12. Christoph Hübener
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Contributions

TK: project development, data collection, and manuscript writing and editing, DF: data collection and data analysis, IR: manuscript editing, MF: manuscript editing, AH: manuscript writing and editing, TMK: data collection and manuscript writing/editing, CD: project development, data collection, and data analysis, MD: data collection and data analysis, KF: project development and manuscript editing, SM: manuscript editing, UH: project development and data collection, CH: data collection, manuscript writing and editing, and project development.

Corresponding author

Correspondence to Thomas Kolben.

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Conflict of interest

S Mahner has received research support, advisory board fees, honoraria, and travel support from AstraZeneca, Bayer, Boehringer Ingelheim, Jenapharm, GSK, JanssenCilag, Medac, MSD, Pharmamar, Roche, Tesaro, and Teva. All other authors declare no conflict of interest.

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Kolben, T., Fischer, D., Ruehl, I. et al. Delayed interval delivery in multiple gestations: the Munich experience. Arch Gynecol Obstet 299, 339–344 (2019). https://doi.org/10.1007/s00404-018-4959-2

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  • DOI: https://doi.org/10.1007/s00404-018-4959-2

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