CLINICAL CHARACTERISTICS AND OUTCOME OF TWIN GESTATION COMPLICATED BYPRETERM PREMATURE RUPTURE OF THE MEMBRANES

OBJECTIVE: Our purpose was to report the clinical characteristics and outcome of twin pregnancy complicated by preterm premature rupture of membranes. STUDY DESIGN: Pregnancy outcome is compared between 99 twin pregnancies and 99 well matched singleton pregnancies complicated by preterm rupture of the membranes. RESULTS: Preterm premature rupture o f membranes occurs more frequently in twin than singleton gestations ( 7.4% vs 3.7%, p < 0.001, odds ratio 2.1). Midtrimester premature ruptu re of membranes (< 26 weeks' gestation) complicated 1.37% of twin gest ations (1 8.2% of those with preterm premature rupture of membranes) v ersus 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% delive red at 7 days for singleton gestations). Latency was prolonged with pr eterm premature rupture of membranes <30 weeks' versus greater-than-or -equal-to 30 weeks' gestation (p = 0.03). The nonpresenting infant mor e frequently had hyaline membrane disease and required more oxygen the rapy than the presenting infant. No significant differences in infecti ous morbidity, cord prolapse, or abruptio placentae were seen between twin and singleton gestations. CONCLUSION: This investigation provides the basis for patient counseling and management subsequent to preterm premature rupture of membranes in twin gestation.