Interval delivery and aggressive tocolysis in high-order multiple gestation. A report of three cases

BACKGROUND: High-order multiple pregnancy (four and above) should be avoided if at all possible. The major fetal risk of high-order multiple gestation is that of extreme prematurity. Interval delivery has been used with twin and triplet pregnancies. CASES: An octuplet, sextuplet and quadruplet pregnancies were managed with interval delivery. The interval from delivery of the first infant to the remainder of pregnancy was 12 days for the octuplet pregnancy, 24 for the sextuplet pregnancy and 12 for the quadruplet pregnancy. CONCLUSION: In high-order multiple pregnancy, delayed interval delivery is strongly recommended, provided that there are no signs of chorioamnionitis, fetal distress or maternal compromise.