2025 Volume 61 Issue 1 Pages 229-233
Delayed-interval delivery（DID）is an option for the management of multiple pregnancies when the first fetus is delivered prematurely and no subsequent fetus is delivered. Although DID improves the prognosis of subsequent babies, reported complications include intrauterine infection. The clinical course of cases in which pregnancy can be prolonged without complications and those in which pregnancy cannot be prolonged is not clear, and there are currently no management guidelines for attempting DID. We encountered 4 cases of dichorionic diamniotic twins who delivered their first fetus between 19 and 25 weeks of gestation and underwent DID. Two patients were able to continue their pregnancies without complications, and both delivered at term. In contrast, two cases in which signs of preterm birth, such as intermittent bleeding and uterine contractions, were observed during pregnancy resulted in preterm births. Although no clear clinical signs of infection were observed in these two cases until just before delivery of the subsequent fetuses, pathological examination of the placenta revealed histological chorioamnionitis. In conclusion, in DID, if signs of preterm birth are observed during pregnancy, it is important to consider the presence of an intrauterine infection as the background, regardless of the objective findings.
