In twin pregnancies, previable rupture of membranes is often complicated by spontaneous preterm delivery, significantly increasing the risks of morbidity and mortality to both fetuses. Delayed-interval delivery, while not a standard approach, is a unique management strategy that can allow the remaining fetus to reach viability in-utero, increasing the chance for neonatal survival. We report a case of delayed-interval delivery in a dichorionic diamniotic twin pregnancy following previable rupture of membranes of twin A at 18 weeks and 5 days (18W5D). Pregnancy was successfully prolonged for 29 days from delivery of twin A to delivery of twin B at 23W3D gestation. This case highlights the potential of delayed-interval delivery to prolong gestation and improve neonatal outcomes, although thorough patient counseling, individualized management, and careful monitoring for detection of maternal and fetal complications are crucial for success.
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