Delayed interval twin delivery of a fetus with a favourable neonatal outcome after a preterm delivery of the first twin: a case report

Abstract

Assisted reproductive techniques have proved to be a boon for infertile couples. With advent of newer techniques, the incidence of successful multiple pregnancies has also risen. Considering the emotional and financial aspects of the treatment and the risk of preterm delivery in such cases, our intent is not only to salvage one of the twins in case of unfortunate preterm delivery of the other but also to deliver a viable second twin with better chance of survival and favourable neonatal outcome. The current case describes a 34-year woman with previous 2 failed IVF conceptions, on external progesterone support, carrying a twin gestation in preterm labour. Upon the inadvertent delivery of the first twin, a cervical cerclage was done, and she was given conservative management, including bed rest and head low position in view of short cervix, with an aim to delay the delivery of the other. An interval of 66 days was achieved with surgical as well as medical management, following which a healthy second twin was born.