Premature delivery in multiple gestation is common. Both infertility and in vitro fertilisation are independent risk factors for preterm delivery. There are exceptional circumstances in which the delivery of a second twin can be delayed after the preterm delivery of the first. This also may apply to triplets and quadruplets under exceptional circumstances.
|
Indications for interval delivery
|
- The placenta(e) of the remaining fetus(es) must be separate from the delivered fetus(es)
|
- Contractions must cease after the delivery of the fetus(es)
|
|
|
- Absence of fetal distress in the retained fetus(es)
|
- Prior to 28 weeks gestation only
|
|
Technique of interval delivery
|
- Adequate analgesia / anaesthesia
|
- High ligation of the umbilical cord with 1 CCG
|
- Postoperative vaginal douche with antiseptic solution
|
- Broadspectrum antibiotic coverage until results of cervical microbiology are available
|
- Corticosteroids to be administered at fetal viability
|
- Maternal and fetal monitoring for evidence of infection
|
- No evidence for the use of:
|
|
|
Royal Women's Hospital Clinical Practice Guidelines (CPGs) are intended to provide guidance to health care professionals, based on a thorough evaluation of research evidence, on the practical assessment and management of specific clinical issues or situations. The guidelines allow some flexibility on the part of the health care professional based on the needs of the specific patient for whom they are caring.
|
Please remember to read our disclaimer.
|
