Delayed interval delivery military style.
BACKGROUND
Intentionally delaying the delivery of a second twin from a previable state to a gestational age when survival is possible is a heroic measure whose outcome is unpredictable. We report the case of delayed interval delivery in a patient transported via air evacuation to a tertiary care center.


METHODS
A 31-year-old gravida 3 para 0020 at 18 weeks with a twin gestation presented to a medical treatment facility for evaluation of uterine cramps. She subsequently delivered Twin A. With cessation of labor, the patient was air evacuated to a medical center for continued care. Seven weeks later, she delivered a viable male infant.


CONCLUSIONS
The treatment of multiple gestations presenting with preterm labor or rupture of membranes remains expectant. When delayed delivery of a previable second twin is undertaken, appropriate care includes the use of antibiotics, tocolytics, and cervical cerclage. Anticipation of preterm birth warrants continued care in a tertiary care center offering neonatal intensive care.
Uniformed Services University of the Health Sciences, Bethesda, MD 20814-5799, USA.
J S
JS
Platt
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Rosa
D000328:Adult; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000000981:diagnostic imaging / Q000628:therapy*; D005865:Gestational Age; D006801:Humans; D008887:Military Medicine / Q000379:methods*; D007752:Obstetric Labor, Premature / Q000000981:diagnostic imaging / Q000628:therapy*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D013997:Time Factors; D014427:Twins; D016216:Ultrasonography, Prenatal; D014481:United States