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Is gestation greater than 28 weeks a contraindication to attempting delayed-delivery in twin pregnancies?

Deliberately delayed delivery of the remaining fetus(es) after preterm delivery of one improves neonatal survival. It was first described in 1880, where a 44-days interval was achieved (Carson 1880). A greater than 2 days delay improved neonatal survival from 24 – 56% in deliveries less than 30 weeks in an analysis restricted to cases where the first twin was liveborn. However, such management is unusual if one fetus delivers at more than 28 weeks, as the risk of infection may outweigh its benefit (Zhang et al. 2004). We report deliberately delayed delivery by 59 days after a demised fetus delivered at 29þ2 weeks. The first delivered twin in the present case was not liveborn, which makes it different from the analysis by Zhang et al. (2004).