The 32-year-old mother from Bac Ninh conceived twins through in vitro fertilization after nearly five years of infertility caused by polycystic ovaries and blocked fallopian tubes. However, complications arose early in the pregnancy.

At around 20 weeks, she showed signs of preterm labor due to cervical dilation. By 22 weeks and five days, her condition had worsened significantly, with the cervix opening 2-3 cm and one fetus descending, with its leg already visible in the vaginal canal.

According to Dr. Truong Minh Phuong, Deputy Head of the High-Risk Obstetrics Department A4, the situation was extremely complex, carrying a high risk of miscarriage or premature delivery.

A multidisciplinary team quickly convened and devised a strategy aimed at prolonging the pregnancy for as long as possible, prioritizing the survival of the second twin while preparing for the likely early delivery of the first.

The patient was treated intensively with medication to suppress contractions and was closely monitored for infection. By week 25, her condition had stabilized, allowing doctors to adjust their approach and attempt to preserve both fetuses.

However, labor resumed at 25 weeks. Doctors worked to extend the pregnancy day by day, noting that each additional week could increase the infant’s survival chances by 20-30%.

At 25 weeks and six days, on January 20, the mother delivered the first baby - a girl weighing 650 grams. The newborn was immediately resuscitated and transferred to the Vietnam National Children's Hospital for intensive care. She has since reached approximately 1.9 kg, is feeding independently, and is now in stable condition.

A tense effort to preserve the second twin

Following the first delivery, the medical challenge intensified. Doctors had to maintain the second fetus in the uterus despite an already dilated cervix and a high risk of infection.

The team continued close monitoring, administered continuous antibiotics, managed the umbilical cord, and carefully controlled all potential complications. Treatment protocols were adjusted dynamically based on the patient’s condition, under the direct supervision of hospital leadership.

After 13 weeks of intensive care, the second twin was successfully carried to 38 weeks. On April 15, the mother underwent a cesarean section, delivering a healthy baby boy weighing 2.4 kg.

Doctors noted that in similar high-risk twin pregnancies, delivery is typically required between 32 and 34 weeks. In this case, however, the pregnancy was extended to full term, allowing for optimal fetal development.

This marks one of the longest recorded intervals between twin births at the hospital. Maintaining the second pregnancy from 26 to 38 weeks - a full 13-week extension - represents an exceptionally rare achievement in obstetric practice worldwide.

Hospital director Mai Trong Hung said the case opens new directions in managing high-risk pregnancies, particularly strategies aimed at prolonging gestation to improve survival rates and developmental outcomes for newborns.

N. Huyen