Gestational age at presentation and duration of latency in twins vs. Singleton pregnancies with pre-term premature rupture of membranes (pPROM)

Abstract

VS. SINGLETON PREGNANCIES WITH PRE-TERM PREMATURE RUPTURE OF MEMBRANES (PPROM) HIREN PATEL, MATTHEW HOFFMAN, THADDEUS WATERS, Christiana Hospital, Newark, Delaware, Drexel University, Obstetrics and Gynecology, Philadelphia, Pennsylvania OBJECTIVE: We sought to determine if there was a difference in latency between singleton and twin gestations following preterm premature rupture of the membranes (pPROM). STUDY DESIGN: Using a contemporaneously maintained database, we identified all women admitted between December 1996 and May 2003 with pPROM !32 weeks with either a singleton or twin gestation. Data abstracted included maternal demographic characteristics, gestational age at delivery, gestational age at rupture of membranes, mode of delivery, and neonatal outcomes. Our primary outcome was duration of latency. Secondary outcomes included gestational age at rupture and percentage of women delivering within 24 hours of pPROM. Univariate and multivariate analysis were used where appropriate. RESULTS: One thousand two hundred and four women had pPROM before 32 weeks (869 singletons and 354 twin gestations). Women with a singleton gestation were no more likely to deliver within 24 hours of presentation than those with multiple gestations (49.3% vs. 53.8%; p=0.264). Among women who did not deliver within the first 24 hours, latency was shorter for women with a singleton versus a twin gestation (11.2 days vs. 14.7 days; p!0.005). In both twins and singletons, length of latency was inversely proportional to gestational age at rupture (p!0.05). Additionally, women with twins were more likely to have pPROM at an earlier gestational age (26.2 weeks vs. 28.0 week-p!0.001). There was no difference in latency period between the groups when controlling for gestational age at pPROM (OR 1.01 95% CI 0.95 to 2.97). CONCLUSION: Women with a twin gestation are more likely to have pPROM at an earlier gestational age than women with a single gestation. There is no difference in latency until delivery between singleton and twin gestations after pPROM.