Intentional delayed delivery in twin pregnancy. Two additional cases and literature review.

We report two cases of retention of the second twin after delivery of the first one. Both pregnancies were bichorionic, biamniotic. In both cases the first twin was delivered during the second trimester. Tocolysis and antibiotics were used. The two pregnancies had a different outcome. For the first patient with a cerclage, the interval delivery was 67 days, allowing a gestational age of 28 weeks and a weight of 1070 g. The child is now 4 years old and has a normal development. In the second case, the second twin was delivered at 20 1/2 weeks, 8 days after the first, and died shortly after birth. Reviewing the literature, 34 twin pregnancies are reported with intentional delay delivery and 27 infants survived out of 68 fetuses. Cerclage does not seem to be essential for success. Prophylactic antibiotics and tocolysis are admitted. The main problem is infection which defines the prognosis.