title: Preterm premature rupture of membranes complicating twin pregnancy: management considerations.
abstract: Preterm premature rupture of membranes (PPROM) is more prevalent in twin gestations and is major contributor to preterm birth. The management of PPROM in twin pregnancies does not differ significantly from that of singletons. In general, antenatal steroids, latency antibiotics, magnesium sulpfate for neuroprotection, and tocolysis are all potential interventions to consider when PPROM complicates a twin gestation. Certain circumstances, such as PPROM following an invasive procedure, at a previable gestational age, or in a monochorionic gestation, warrant special attention as the implications of PPROM and subsequent recommendations for these twin pregnancies may differ. In general, the approach to PPROM in twins should be individualized based on gestational age, and the maternal and neonatal risks of delaying delivery to prolong the pregnancy.
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Medical Center New York, New York, USA. hys2104@columbia.edu
authors.forename: Hen Y
authors.initials: HY
authors.lastname: Sela
authors.forename: Lynn L
authors.initials: LL
authors.lastname: Simpson
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use; D036861:Delivery, Obstetric; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000188:drug therapy*; D005865:Gestational Age; D006801:Humans; D008278:Magnesium Sulfate / Q000627:therapeutic use; D011247:Pregnancy; D011272:Pregnancy, Multiple; D013256:Steroids / Q000627:therapeutic use; D015145:Tocolysis; D015149:Tocolytic Agents / Q000627:therapeutic use; D014427:Twins
chemical_list: D000890:Anti-Infective Agents; D013256:Steroids; D015149:Tocolytic Agents; D008278:Magnesium Sulfate