Delayed interval delivery military style

Abstract

Introduction: Intentionally delaying the delivery of a second twin from a previable state to a gestational age when survival is possible is a heroic measure whose outcome is unpredictable. We report the case of delayed interval delivery in a patient transported via air evacuation to a tertiary care center.

Case report: A 31-year-old gravida 3 para 0020 at 18 weeks with a twin gestation presented to a medical treatment facility for evaluation of uterine cramps. She subsequently delivered Twin A. With cessation of labor, the patient was air evacuated to a medical center for continued care. Seven weeks later, she delivered a viable male infant.

Discussion: The treatment of multiple gestations presenting with preterm labor or rupture of membranes remains expectant. When delayed delivery of a previable second twin is undertaken, appropriate care includes the use of antibiotics, tocolytics, and cervical cerclage. Anticipation of preterm birth warrants continued care in a tertiary care center offering neonatal intensive care.