Outcomes of preterm premature rupture of membranes in twin pregnancies

Objective. To describe outcomes in twin pregnancies with preterm premature rupture of membranes (PPROM).

Methods. Dichorionic twin pregnancies complicated by PPROM at <34 weeks of gestation for the period 2003 to 2006 were identified. Outcomes were obtained through chart review. The relationship between gestational age at premature rupture of membranes (PROM), latency from PROM to delivery, and infection were examined.

Results. In 49 twin pregnancies, the median gestational age at PROM was 31 weeks with a median latency between PROM and delivery of 0 days (interquartile range 0–6). Latency intervals of ≥2 and ≥7 days were achieved by 40.8% and 22.4%, respectively. PPROM at <30 weeks was associated with significantly higher rates of latency of ≥ 2 days (70.6% vs. 25.0%) and ≥7 days (47.1% vs. 9.4%). There was a significant relationship between latency and clinical and histologic signs of infection.

Conclusions. After 30 weeks, most twin pregnancies with PPROM delivered within 2 days. Infection appears to be a consequence rather than a cause of PPROM in most cases.