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Case Reports: Learning from unexpected outcome (positive or negative)
Successful delayed interval delivery of a triplet pregnancy using conservative management
  1. Fanny Eckel1,
  2. Katrin Klebermass-Schrehof2,
  3. Zsuzsanna Bago-Horvath3 and
  4. Alex Farr1
  1. 1Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-Maternal Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
  2. 2Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Intensive Care Medicine and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
  3. 3Clinical Institute of Pathology, Medical University of Vienna, Vienna, Austria
  1. Correspondence to Professor Alex Farr; alex.farr{at}meduniwien.ac.at

Abstract

Preterm birth is a significant cause of perinatal morbidity and mortality, especially in multiple pregnancies. Delayed interval delivery can prolong pregnancy for the remaining fetus(es) in an imminent stillbirth or extremely preterm birth of the first fetus, improving the lastborn’s outcomes. We present a case of delayed interval delivery of a triplet pregnancy following preterm prelabour rupture of membranes and progressive cervical insufficiency. Following vaginal delivery of the first fetus at 24+1 gestational weeks, the patient received antibiotics and tocolysis. Cerclage was not conducted as the mother had a vaginal infection. A 15-day delivery interval for the second and third fetuses was achieved. The firstborn required mechanical ventilation and inotropic support, while the others only required continuous positive airway pressure. There is no consensus on the best way to perform delayed interval delivery. We achieved a complications-free interval of 15 days with conservative management in a triplet pregnancy.

  • Obstetrics and gynaecology
  • Pregnancy
  • Neonatal health
  • Materno-fetal medicine
  • Neonatal and paediatric intensive care

https://doi.org/10.1136/bcr-2023-254705

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content; gave final approval of the manuscript: FE, KK-S, ZB-H and AF.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.