Preterm Prelabour Rupture of Membranes before Viability in Twin Pregnancies: What Can We Expect?
Por:
Ponce J, Cobo-Cobo T, Murillo C, Gonce A, Domínguez N, Crovetto F, Guirado L, Palacio-Navarro A and Mar Bennasar Sans
Publicada:
1 abr 2023
Ahead of Print:
18 abr 2023
Categoría:
Medicine (miscellaneous)
Resumen:
Preterm prelabour rupture of membranes (PPROMs) before viability carries significant perinatal mortality and morbidity. Clinical management and prenatal counselling are a challenge, especially in twin pregnancies, due to scarce evidence on how previable PPROM affects this population. The aim of this study was to describe pregnancy outcomes of twin pregnancies complicated with previable PPROM and evaluate potential prognostic factors that may predict perinatal mortality. A retrospective cohort including dichorionic and monochorionic diamniotic twin pregnancies complicated with PPROM before 24 + 0 weeks of pregnancy was evaluated. Perinatal outcomes of pregnancies managed expectantly were described. Factors predicting perinatal mortality or reaching periviability (defined from 23 + 0 weeks onwards) were evaluated. Of the 45 patients included, 7 (15.6%) spontaneously delivered within the first 24 h after diagnosis. Two patients (5.3%) requested selective termination of the affected twin. In the 36 ongoing pregnancies that opted for expectant management, the overall survival rate was 35/72 (48.6%). There were 25/36 (69.4%) patients who delivered after 23 + 0 weeks of pregnancy. When periviability was achieved, neonatal survival increased up to 35/44 (79.5%). Gestational age at delivery was the only independent risk factor of perinatal mortality. The overall survival rate of twin pregnancies complicated with previable PPROM is poor but similar to singletons. No prognostic factors, apart from achieving periviability, were identified as individual predictors of perinatal mortality.
Filiaciones:
Ponce J:
BCNatal, Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, 08028 Barcelona, Spain
Cobo-Cobo T:
BCNatal, Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, 08028 Barcelona, Spain
:
BCNatal, Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, 08028 Barcelona, Spain
Gonce A:
BCNatal, Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, 08028 Barcelona, Spain
Domínguez N:
BCNatal, Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, 08028 Barcelona, Spain
Crovetto F:
BCNatal, Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, 08028 Barcelona, Spain
Institut de Recerca Sant Joan de Déu, 08950 Esplugues de Llobregat, Spain
:
BCNatal, Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, 08028 Barcelona, Spain
Palacio-Navarro A:
BCNatal, Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, 08028 Barcelona, Spain
Mar Bennasar Sans:
BCNatal, Fetal Medicine Research Center, Hospital Clínic and Hospital Sant Joan de Déu, 08028 Barcelona, Spain
Green Submitted, gold
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