article = {CROGR-2020-1-106}
title = {Beating the Record: 157 Days of Delayed Delivery of The Second Fetus in a Twin Pregnancy}
journal = {Case Reports in Obstetrics Gynecology and Reproductive}
year = {2020}
issn = {2674-5070}
doi = {http://dx.doi.org/10.31487/j.CROGR.2020.01.06}
url = {https://www.sciencerepository.org/beating-the-record-157-days-of-delayed-delivery-of-the_CROGR-2020-1-106 
author = {D. Borniquel  Agulló,F. Xavier González Tallada,I. Llordella  Sarmiento,Javier Medrano Juárez,Lourdes Sala Climent,M.J. Pelegay  Escartín,N. Redondo  López,}
keywords = {Multiple pregnancy, twin, preterm delivery, cervical incompetence, cerclage, interval delivery}
abstract ={Case Report: We present the case of a diamniotic-dichorionic twin pregnancy of 14+4 weeks with obstetric
history of cervical incompetence. The premature delivery of the first twin took place, with unfortunate
outcome. The second twin was left in utero. The management, at first, included combination of expectant
attitude with a close monitoring of maternal constants and analysis, and administration of antibiotics; in a
second step, after discarding intraamniotic infection, a McDonald cerclage was performed with success. At
37 weeks the cerclage was removed and after Oxytocin induction, a healthy baby was born.
Conclusion: Delayed delivery of the second fetus in a twin pregnancy is an effective management choice.
The use of cervical cerclage after the first delivery is associated with a longer inter-delivery interval. The
behaviour in these unusual cases should be assessed individually, due to the scarce literature on the matter
and the lack of unanimous protocols. But, always considering the maternal and fetal status, trying to improve
perinatal results with a strict maternal surveillance to discard the appearance of a possible intraamniotic
infection.}