Abstract
To describe the perinatal outcomes of twin pregnancies with preterm premature rupture of membranes (PPROM) before 34 weeks’ gestation and identify factors associated with discharge without severe or moderate-severe neonatal morbidity. This study was conducted as a retrospective analysis of twin pregnancies with PPROM occurring at 24 0/7 to 33 6/7 weeks’ gestation. Perinatal outcomes were assessed by gestational age (GA) at PPROM and compared between PPROM and non PPROM twins. Factors associated with discharge without severe or moderate-severe neonatal morbidity were identified using logistic regression analysis. Of the 180 pregnancies (360 foetuses), only 17 (9.4%) women remained pregnant 7 days after PPROM. There were 10 (2.8%) cases of prenatal or neonatal death; 303 (84.2%) and 177 (49.2%) neonates were discharged without severe or moderate-severe morbidity, respectively. As GA at PPROM increased, the adverse obstetric and neonatal outcomes decreased, especially after 32 weeks. There was no significant difference in general neonatal outcomes between PPROM and non PPROM twins. The GA at PPROM and latency period were both significantly associated with discharge without severe or moderate-severe neonatal morbidity. Pregnancy complications and 5-min Apgar score < 7 increased severe neonatal morbidity. As GA at PPROM increased, the risk of adverse perinatal outcomes decreased. GA at PPROM and latency period were significantly associated with discharge without severe or moderate-severe neonatal morbidity.
Highlights
Preterm premature rupture of membranes (PPROM), defined as membrane rupture before 37 weeks’ gestation, accounts for 3% of all p regnancies[1]
When twin pregnancies experienced PPROM at 24 0/7 to 33 6/7 weeks’ gestation, half of the cases delivered within 24 h after PPROM and one in 10 cases remained undelivered for 7 days or more
We concluded that gestational age (GA) at PPROM and latency period were positively related to hospital discharge without severe or moderate-severe neonatal morbidity, which is consistent with the findings of previously published studies[11,12]
Summary
Preterm premature rupture of membranes (PPROM), defined as membrane rupture before 37 weeks’ gestation, accounts for 3% of all p regnancies[1]. Prematurity, which is the primary neonatal consequence of PPROM, is a major contributor to perinatal morbidity and mortality, and 25–30% of preterm births are attributed to P PROM3. Twin pregnancies are more likely to have a shorter duration from membrane rupture to delivery, a higher risk of earlier delivery, and adverse neonatal outcomes than singleton pregnancies[6,7]. The present study aimed to describe the obstetric and neonatal outcomes of twin pregnancies with PPROM at 24 0/7 to 33 6/7 weeks’ gestation stratified by GA at membrane rupture and identify factors associated with discharge without severe or moderate-severe morbidity
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