Asynchronous multiple birth. A report of five cases.

The feasibility of prolonging the delivery interval of the fetus or fetuses in multiple gestations after the preterm delivery of one fetus has been demonstrated. Five clinical reports and a literature review served as the database for this study. Pregnancy was extended in each of five patients with multiple gestations after the extreme preterm delivery of one fetus. Four of the six remaining infants survived. The literature reviewed shows successful survival in 42 of 52 (81%) such asynchronously delivered infants. Use of tocolytic therapy, broad-spectrum antibiotics and cerclage allows pregnancy extension when delivery occurs asynchronously in multiple gestations. The patient's strong desire and full understanding of the potential risks are mandatory before such an endeavor is attempted.