Delayed-interval delivery: Extended series from a single maternal-fetal medicine practice

OBJECTIVE: Our purpose was to review the extended experience of a single ma ternal-fetal medicine practice with delayed-interval delivery. STUDY DESIGN: We completed a retrospective review of our maternal-fetal med icine practice database from January 1991 through March 1999. Patients were derived from both primary and consultative practices. All patients were ma naged with tocolysis, antibiotics, and cerclage after delivery of the first fetus(es). Retained siblings were investigated by amniocentesis to exclude intra-amniotic infection. RESULTS: Twenty-four consecutive patients had attempted delayed-interval de livery. Exclusion criteria for delayed-interval delivery included monochori onicity, abruptio placentae, severe preeclampsia, and the need for hysterot omy The mean latency interval was 36 days, with a range of 3 to 123 days. A dditionally, patients with previous cerclage(s) had significantly shorter m ean latency intervals than patients without previous cerclage(s). Patients with long latency intervals (greater than or equal to 49 days) had earlier births of the first fetus. CONCLUSION: Selected multichorionic pregnancies may benefit from delayed-in terval delivery. Patients with previous cervical cerclage(s) during the ind ex pregnancy are less likely to achieve significant latency intervals. Even modest intervals between births of siblings at critical gestational ages c an improve neonatal survival and decrease neonatal morbidity.