Clinical characteristics and outcome of twin gestation complicated by preterm premature rupture of the membranes.

Abstract

Our purpose was to report the clinical characteristics and outcome of twin pregnancy complicated by preterm premature rupture of membranes. Pregnancy outcome is compared between 99 twin pregnancies and 99 well matched singleton pregnancies complicated by preterm rupture of the membranes. Preterm premature rupture of membranes occurs more frequently in twin than singleton gestations (7.4% vs 3.7%, p < 0.001, odds ratio 2.1). Midtrimester premature rupture of membranes (< 26 weeks' gestation) complicated 1.37% of twin gestations (18.2% of those with preterm premature rupture of membranes) versus 0.52% of singleton gestations (p < 0.001, odds ratio 2.71). The mean gestational age at preterm premature rupture of membranes was 30.1 +/- 4.3 weeks. The median latency to delivery for twins was 1.1 days with 91% of patients delivered within 7 days (vs 1.7 days, 90% delivered at 7 days for singleton gestations). Latency was prolonged with preterm premature rupture of membranes < 30 weeks' versus > or = 30 weeks' gestation (p = 0.03). The nonpresenting infant more frequently had hyaline membrane disease and required more oxygen therapy than the presenting infant. No significant differences in infectious morbidity, cord prolapse, or abruptio placentae were seen between twin and singleton gestations. This investigation provides the basis for patient counseling and management subsequent to preterm premature rupture of membranes in twin gestation.