A delayed interval delivery (DID) after a single fetal demise in dichorionic diamniotic twin pregnancy

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  • MATSUMOTO Masuyo
    Department of Obstetrics, Hyogo prefectural Kobe Children’s Hospital
  • TAIRAKU Shinya
    Department of Obstetrics, Hyogo prefectural Kobe Children’s Hospital
  • KANEKO Megumi
    Department of Obstetrics, Hyogo prefectural Kobe Children’s Hospital
  • KUBOTA Shino
    Department of Obstetrics, Hyogo prefectural Kobe Children’s Hospital
  • OGINO Michi
    Department of Obstetrics, Hyogo prefectural Kobe Children’s Hospital
  • FUNAKOSHI Toru
    Department of Obstetrics, Hyogo prefectural Kobe Children’s Hospital

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  • 二絨毛膜二羊膜双胎の1児胎内死亡後にdelayed interval delivery（DID）で出産となった1例
  • ニジュウモウマク ニ ヨウマクソウタイ ノ 1ジ タイナイ シボウ ゴ ニ delayed interval delivery (DID)デ シュッサン ト ナッタ 1レイ

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Abstract

<p>DID is defined as occurring when a pregnancy continues for at least 24 hours beyond the birth of a singleton in a multiple pregnancy. Some literature discuss DID, but not a single fetal demise in a twin pregnancy. We present a case of DID in a dichorionic diamniotic twin pregnancy after a single fetal reduction. The patient was 32-year-old pregnant Japanese woman, G1P0. At 15th weeks gestation, a large encephalocele was found in one twin, and the patient selected a fetal reduction at 17th weeks gestation in another hospital. At 28th weeks 4days gestation, the twin that had died in utero was delivered, and the remaining fetal membrane prolapsed into the vagina. The patient was admitted to our hospital and treated with tocolytic agents, progesterone replacement, antibiotics, and corticosteroids. The remaining fetus was delivered four days later at 29th weeks 1day gestation. The placental pathology of the demised fetus was chorioamnionitis. The baby’s progress was good, and she was discharged on the 76 days of life. There are reports of DID decreasing neonatal morbidity because too little gestational age is dangerous. The decision to select DID should be made with great care after considering gestational age and any signs of infection. [Adv Obstet Gynecol, 75 (1) : 51-56, 2023 (R5.2)]</p>

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