Hindawi Publishing Corporation Case Reports in Obstetrics and Gynecology Volume 2012, Article ID 573824, 3 pages doi:10.1155/2012/573824 Case Report Delayed Interval Delivery of a Second Twin after the Preterm Labor of the First One in Twin Pregnancies: Delayed Delivery in Twin Pregnancies Yunus Aydin1 and Murat Celiloglu2 1 Department of Obstetrics and Gynecology, Eskisehir Osmangazi University Medical Faculty, 26000 Eskisehir, Turkey 2 Department of Obstetrics and Gynecology, Dokuz Eylul University Medical Faculty, 35000 Izmir, Turkey Correspondence should be addressed to Yunus Aydin, aydin.yunus@yahoo.com Received 23 March 2012; Accepted 14 May 2012 Academic Editors: J. Higgins, E. F. C. Murta, and S. Salhan Copyright © 2012 Y. Aydin and M. Celiloglu. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. A diamnionic dichorionic twin pregnant women (due to in vitro fertilization) admitted to emergency department at the 21st week of gestation because of regular contractions. By gynecological examination, we observed 8 cm dilated cervix with 80% eﬀacement. Amniotic membrane was also bulging through the cervix. After evaluation delivery of the presenting fetus occurred quickly. The baby’s weight was 610 gr and no heart activity was detected. Placenta of the ﬁrst fetus expulsed immediately. We decided to retain the second fetus to allow the improvement in the outcome. McDonald cerclage was performed and the patient treated with tocolytics and antibiotics, and she was continuously monitored up to the 28th week of pregnancy. After she was discharged in the 28th week, she was controlled weekly in obstetrics clinic. At the 36th gestational week which was 101 days after the cerclage pro- cedure, 3639 g male fetus was delivered with cesarean section and had an uneventful neonatal course. Delayed-interval delivery is useful and acceptable therapeutic option for the management of the remaining fetus in twin pregnancies even after the expulsion of the placenta. Antibiotic and tocolytic administration with cervical cerclage application can be associated with longer interdelivery interval. 1. Introduction Preterm delivery is associated with high risk for neonatal mortality and morbidity [1]. In twin pregnancies, there is a high risk of preterm delivery, that is, about 4%, 8%, 16% for delivery before the 30th, 32th, and 34th weeks, respectively, [2]. In the last decades, the number of multiple pregnancies have increased as a result of assisted reproductive technolo- gies [3]. As a result, preterm labor in the second trimester and the premature rupture of membranes of the presenting fetus have now been encountered more commonly by peri- natologist. Delivery of the presenting fetus in multiple gesta- tion is usually followed by delivery of the second fetus or fetuses shortly thereafter [4]. Although case reports have demonstrated that delayed interval delivery can be success- fully achieved in selected cases, optimal management is not clearly deﬁned [4–11]. We report a case of delayed delivery with a interval of 101 days after the delivery of the ﬁrst twin. 2. Case Report A diamnionic dichorionic twin pregnant women (due to in vitro fertilization pregnancy) admitted to emergency depar- tment at the 21st week of gestation because of regular con- tractions. She had two embryo transfers after a successful ART cycle. Pelvic examination revealed bulging membranes and a dilated cervix at 8 cm. Thereafter rapid delivery of the pre- senting fetus occurred. Delivered fetus weighed 610 g and no heart activity was detected. Placenta of the ﬁrst fetus expulsed in 2-3 minutes after delivery easily. Patient was informed about the option for delaying the remaining fetus and also the complications of treatment for fetus and for herself. Amniotic membrane of the remaining fetus was intact and the fetal heart monitorizations were normal during the followup. Plasental and cervical cultures were taken. Con- sequently vagina and the lower pole of the remaining sac