Delayed interval delivery (DID) is the intervention to improve prognosis of the remaining fetus(es) after delivery of the first born in pre- or peri-viable gestation. This research registry will collect information directly from the affected women or health care professionals. This information will help us understand the impact of DID and organize a randomized controlled trial in the future.
Multiple pregnancy increases the risk of miscarriage and preterm birth. If delivery occurs in pre- or peri-viable gestation, the chance of perinatal survival of the infant is slim, or the surviving infant may be living with profound perinatal morbidities.
DID refers to the intention to delay the delivery of the remaining fetus(es) after the firstborn, aiming to prolong the gestation and thus improve neonatal outcomes. In a meta-analysis, we found that DID for pre- or peri-viable pregnancy could significantly improve perinatal survival of the remaining fetus(es). However, severe maternal morbidity was reported in 39% of pregnancies after DID.
The optimal management of DID remains controversial, for example, the use of antibiotics, high ligation of the umbilical cord of the firstborn, vaginal cleansing using anti-septic, tocolytic treatment and cervical cerclage. A randomized controlled trial is the ideal research model to compare treatment efficacies and identify the most effective management protocol for this intervention. However, we expect difficulty in subject recruitment given the rarity of this condition. Therefore, we have set up this registry to prospectively gather data to evaluate the effect of DID, as well as invite centers worldwide to participate in an international randomized controlled trial. These data will be used only by the Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, for scientific purposes with a prospect to generate evidence for social benefit, as well as research publication in a peer-review journal.
It is up to you to decide whether or not to take part. If you decide to take part you are still free to withdraw at any time and without giving a reason. By filling in the clinical information, you consent to this registry using your data to study the effect of DID (or you can ask your clinician to fill in the data on your behalf with your consent).
All information collected about you during the course of the research will be kept strictly confidential. We will make every effort to ensure strict confidentiality. Information obtained in this study will only be used for research and educational purposes.
If you agree (or have consent from your patient) to participate in this research registry, please use the following link to register information: https://hku.au1.qualtrics.com/jfe/form/SV_ezeWvIOREWjEyzk
