‘Interval birth’: Expert describes rare case of twins born weeks apart

A rare medical case in which a woman gave birth to one twin at a district hospital and delivered the second nearly two weeks later at a different facility has drawn attention. 

Professor of obstetrics and gynaecology at the University of the Free State Ray Maharaj said while similar cases have occurred in SA, “it’s rare and you don’t see it often”. 

The delayed delivery of non-identical twins, known as an “interval delivery”,  occurs under specific conditions.

Maharaj said this happens in an emergency and can only occur through natural birth.

The Free State health department confirmed a woman recently gave birth to twin boys 14 days apart in two different provinces.

Department spokesperson Mondli Mvambi said the first twin was delivered at Kuruman Hospital in the Northern Cape on March 27, and the second was delivered at Universitas Academic Hospital in Bloemfontein on April 10.

“The second child was born in our facility, a university academic hospital. Unfortunately, when we were hoping to celebrate the miracle of the baby, we received information it has died,” he said.

Mvambi said the mother is in hospital receiving medical care.

Maharaj said the patient likely went into preterm labour, a condition where labour begins before the baby is fully matured. 

“Preterm labour occurs before 37 completed weeks. In these patients we usually find they go into preterm labour between six to six-and-a-half months. What can happen is one can be delivered because the mother is in labour.”

He said there are several reasons why women can go into preterm labour, including the rupture of membranes (the water bag bursting), infections during pregnancy or a weakened cervix that becomes soft and cannot stay closed. 

These factors can trigger labour before 37 weeks.

Maharaj said in this case the first baby is usually born like any other normal pregnancy and the second remains inside.

“That baby doesn't have abnormal signs, no infection, no labour, everything is fine. Baby is sitting inside quietly and wants to stay there. The mother is well, the baby is well, there are no complications.

“We clamp the umbilical cord as high as possible. We tie it up, cut it off, tie the end and leave it inside, and we leave the second baby inside.”

He said this is done as the second baby is not yet mature and they wait to see how much longer the baby can stay inside the womb and continue to grow.

“There's an interval between the first and the second,” Maharaj said.

He said the procedure can only be done if the twin babies do not share a sac.

Maharaj said after the procedure the mother and baby require medical care.

“We have to give the patient antibiotics to prevent infection. We have to give her drugs to stop her from going into preterm labour because we don't want the second baby to come out preterm.”

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