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.

Material and 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.

Conclusion: 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.