Introduction:
We present a case of twin survivors, born at the edge of viability, without any major morbidities, and despite unfavorable factors.1,2 We believe that they are one of the youngest twin survivors ever reported and the only twins without major complication for both. The risk factors for them included twin birth, male sex of the second twin who had birth weight of less than 500 g, poor antenatal care, late administration of steroids, and prolonged maternal rupture of membranes with chorioamnionitis. Since the twins were conceived via in vitro fertilization (IVF), the gestational age could be confirmed as 22 2/7 weeks. However, neither infant developed serious complications, such as intraventricular hemorrhage or necrotizing enterocolitis.
In this report, we share our experience in the United Arab Emirates and reflect on how the advances in management strategies have decreased the viability threshold to 22 weeks. This case added to our expertise and our clinical and communication protocols. It has changed our perspective on resuscitation near viability and has led to a shift toward considering more active resuscitation in our perinatal discussions with parents