Outcome of dichorionic diamniotic twin pregnancies with spontaneous PPROM before 24 weeks' gestation.
OBJECTIVE
The objective of this study is to examine the outcome in dichorionic diamniotic twin pregnancies with rupture of membranes (PPROM) before 24 weeks' gestation.


METHODS
Retrospective analysis of fetal and neonatal outcomes in women with spontaneous PPROM before 24 weeks' gestation that were treated at a single tertiary center.


RESULTS
Twenty-nine pregnancies fulfilled the inclusion criteria. Mean gestational age at the time of PPROM was 20.4 weeks. Two women opted for termination. The remaining 27 (93.1%) women elected for expectant management. Ten (37.0%) of these delivered before 24 + 0 weeks' gestation. The median gestational age at the time of delivery in the remaining 17 (63%) cases was 26.4 weeks. In those patients that did not deliver within the first 5 days of PPROM, the chance of reaching 24 + 0 weeks was 85%. Co-twins that had PPROM compared with those without PPROM suffered more often from several neonatal complications. Overall, about 40% of the fetuses in the PPROM group and 70% of the non-PPROM group survived without major complications.


CONCLUSIONS
Dichorionic diamniotic twin pregnancies with PPROM prior to 24 + 0 weeks' gestation have a 60% chance of delivering at >24 weeks. Survival rates without major complications in twins with and without PPROM are 40% and 70%, respectively.
a Department of Obstetrics and Gynecology , University of Tuebingen , Tuebingen , Germany.
Philipp
P
Wagner
b Fetal Medicine Foundation USA , Dayton , OH , USA.|c Division of Maternal Fetal Medicine , Wright State University , Dayton , OH , USA , and.
Jiri
J
Sonek
a Department of Obstetrics and Gynecology , University of Tuebingen , Tuebingen , Germany.
Stefanie
S
Mayr
a Department of Obstetrics and Gynecology , University of Tuebingen , Tuebingen , Germany.
Harald
H
Abele
d Department of Neonatology , University of Tuebingen , Tuebingen , Germany.
Rangmar
R
Goelz
a Department of Obstetrics and Gynecology , University of Tuebingen , Tuebingen , Germany.
Markus
M
Hoopmann
a Department of Obstetrics and Gynecology , University of Tuebingen , Tuebingen , Germany.
Karl Oliver
KO
Kagan
D000328:Adult; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D059285:Pregnancy, Twin; D012189:Retrospective Studies
Dichorionic diamniotic twin pregnancies; PPROM; neonatal; outcome; preterm; previable