EP14.25: Twin delayed interval delivery at a tertiary centre: a case series
Bibliographic record
Abstract
To describe the management and perinatal outcomes when delayed interval delivery (DID) of the second and third fetuses was employed as first option for multiple pregnancies. Retrospective chart review of all cases of DID from January to December 2022 at The Ottawa Hospital (TOH), a high-risk pregnancy tertiary centre in Canada. Five cases of DID were identified and reviewed to obtain information on management, maternal and neonatal outcomes. We included all eligible multiples. Data collected include maternal age at delivery, chorionicity, mode of delivery and gestational age, antibiotics received, use of corticosteroids, and newborn outcomes such as weight and duration of hospital stay. Ethics approval was obtained. This case series describes our experience managing 5 cases of DID, totalising 4 sets of dichorionic diamniotic twins and one trichorionic-triamniotic triplet. Gestational age at admission varied from 17 to 23 weeks of gestation. Interval delivery ranged between 1 and 36 days. Nine out of 11 twins did not survive the DID. Neonatal mortality was explained due to severe prematurity at the time of delivery. The 2 surviving newborns were born at 23 and 23 weeks, 36 and 6 days after the first twin was born. Both had received full course of steroids. They were admitted to NICU for 111 and 131 days and discharged with weighing 3594 and 2743g. All DID were spontaneous except for one fetus that required surgical evacuation due to maternal sepsis. Different antibiotic regimens were used as no local protocol has been established for DID practices. Despite the high risk of maternal, fetal and neonatal morbidity and mortality, management of DID is still individualised. The information collected from this case series adds evidence to the current controversial body of literature regarding DID. Our results strengthened our experience and enabled proper patient counselling and decision-making.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".