Why the study?
Does conservative management improve survival in DCDA twin pregnancies with extreme prematurity after delivery of the first twin?
Does conservative management improve survival in DCDA twin pregnancies with extreme prematurity after delivery of the first twin?
Conservative management of the second twin in extreme prematurity increases survival by approximately 10% per week, though maternal infection risks remain a concern.
May inform individualized timing in extreme preterm twins; leaves open optimal strategies pending prospective trials.
Due to increased use of ART delayed twin interval delivery has become a common occurrence. Multiple pregnancy is associated with high incidence of premature labour. Prematurity is the leading cause of neonatal morbidity and mortality all over the world as premature babies are at a greater risk of dying and has other health issues. Delivery of the presenting fetus usually followed by delivery of the second fetus shortly thereafter. There is no study available for the management of multifetal pregnancy, where one twin had delivered very prematurely and the time interval of the delivery for subsequent fetus. Conservation of pregnancy has good outcome when properly managed with careful surveillance. Survival rate increases by approximately 10% every week conserved in utero. Reservation persist in anticipation of increased maternal morbidity and mortality due to infection after conservative management.Time interval remains a dilemma in extreme prematurity.
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Sinha et al. (2018) studied this question.
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