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Am J Perinatol 2011; 28(2): 091-096
DOI: 10.1055/s-0030-1262513
© Thieme Medical Publishers

Maternal and Neonatal Outcomes after Delayed-Interval Delivery of Multifetal Pregnancies

Ashley S. Roman1 , Shira Fishman1 , Nathan Fox1 , Chad Klauser1 , Daniel Saltzman1 , Andrei Rebarber1
  • 1Department of Obstetrics and Gynecology, New York University School of Medicine, New York, New York
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Publication History

Publication Date:
06 July 2010 (online)

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ABSTRACT

The objective of this study is to evaluate neonatal and maternal outcomes of multiple gestations undergoing delayed-interval delivery at a single institution. A 10-year retrospective review of medical records of patients followed by a Maternal-Fetal Medicine practice in a university-based setting was performed. Patients met criteria for inclusion if a single fetus was delivered spontaneously between 16 and 28 weeks of gestation and a planned attempt was made to prolong the gestation for the remaining fetus(es). Nineteen pregnancies met criteria for inclusion. The median gestational age at delivery of the first fetus was 202/7 weeks and the last fetus was 251/7 weeks. The median latency was 16 days (range 0 to 152 days). Three patients (15.8%) delivered within 24 hours. There was a 15.8% survival rate for the firstborn fetus and a 53.8% survival rate for all retained fetuses (p = 0.01). There was a 31.6% incidence of serious maternal morbidity related to the procedure. One patient required a postpartum hysterectomy due to massive hemorrhage and uterine atony. Delayed-interval delivery is associated with a higher neonatal survival rate when retained fetuses are compared with firstborn fetuses. However, the procedure is associated with a significant risk of serious maternal morbidity.

KEYWORDS

Multifetal pregnancy - delayed-interval delivery - neonatal morbidity - maternal morbidity

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Ashley S RomanM.D. M.P.H. 

70 East 90th Street

New York, NY 10128

Email: ashley.roman@nyumc.org

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