Nonconventional approach to twin pregnancies complicated by extremely preterm premature rupture of membranes of one twin

The common management in most centers in cases of multiple pregnancies with preterm premature rupture of membranes (PPROM) before 22 weeks of gestation is termination of the pregnancy or the expectant approach. Expectant management of previable PPROM in twin pregnancies results in an increased rate of fetal and neonatal morbidity and mortality of both twins. Selective fetocide of the twin with early midtrimester rupture of membranes may improve the unfavorable pregnancy outcome of the remaining fetus. We report two successful cases of twin pregnancies complicated by extremely PPROM managed by selective fetocide of the affected twin, with an uneventful single pregnancy course and delivery of healthy newborns at 36 weeks of gestation.