A Delayed-interval Delivery of An in vitro-fertilized Twin Pregnancy with Premature Rupture of Membranes

This article presents a case of conservative managements of an in vitro-fertilized twin pregnancy with early loss of the first fetus. A 37-year-old woman in the 21st week of a twin pregnancy delivered her one of the fetuses with unfortunate outcome after the premature rupture of membranes. The umbilical cord of the first fetus was ligated at the cervical level and the second surviving fetus was left in utero. In order to save the surviving fetus, conservative managements including combination of steroids, tocolytics, antibiotics and cervical cerclage were performed. The second fetus was delivered vaginally in the 27th week of pregnancy, 4 h after premature rupture of membranes of the remaining amniotic sac, 41 d after the first fetus was born. The child and the mother have been followed up for 4 years and they are healthy. Conservative managements including steroids, tocolytics, antibiotics and cervical cerclage in a closely monitored environment would be given following the delivery of the first fetus. Delayed-interval pregnancy appears to be safe for the mother and the remaining fetuses.