TY - JOUR
AR - CROGR-2020-1-106
TI - Beating the Record: 157 Days of Delayed Delivery of The Second Fetus in a Twin Pregnancy
AU - D. Borniquel , Agulló
AU - F. Xavier, González Tallada
AU - I. Llordella , Sarmiento
AU - Javier, Medrano Juárez
AU - Lourdes Sala, Climent
AU - M.J. Pelegay , Escartín
AU - N. Redondo , López
JO - Case Reports in Obstetrics Gynecology and Reproductive
PY - 2020
DA - Fri 29, May 2020
SN - 2674-5070
DO - http://dx.doi.org/10.31487/j.CROGR.2020.01.06
UR - https://www.sciencerepository.org/beating-the-record-157-days-of-delayed-delivery-of-the_CROGR-2020-1-106 
KW - Multiple pregnancy, twin, preterm delivery, cervical incompetence, cerclage, interval delivery
AB - 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.