Results of expectant management in singleton and twin pregnancies complicated by preterm premature rupture of membranes

Ginekol Pol. 2022;93(12):999-1005. doi: 10.5603/GP.a2021.0211. Epub 2022 Feb 2.


Objectives: This study aimed to examine whether expectant management in twin pregnancies with preterm premature rupture of membranes (pPROM) is as safe as in singleton pregnancies.

Material and methods: It was a retrospective cohort study comparing pregnancy course and outcome in singleton (n = 299) and twin pregnancies (n = 49) complicated by preterm premature rupture of membranes. Analysed factors included maternal diseases, gestational age at premature rupture of membranes (PROM), management during hospitalization, latency periods between PROM and delivery, gestational age at delivery, neonatal management and outcome.

Results: The difference in the proportion of patients with latency up to 72 hours, latency between 72 hours and seven days, and latency exceeding seven days were insignificant. The percentage of patients who received intravenous tocolysis and antenatal corticosteroids were similar; however, patients in twin pregnancies more often received incomplete steroids dose (p = 0.01). The occurrence of the positive non-stress test result and signs of intrauterine infection were similar between the groups. No statistically significant differences in the prevalence of neonatal complications except transient tachypnoea of the newborn were identified (24% in the singleton vs 13% in the twin group, p = 0.03).

Conclusions: Expectant management of pPROM in singleton and twin pregnancies results in similar perinatal and neonatal outcome. Consequently, in case of no evident contraindications, expectant management of twin pregnancies seems to be equally as safe as in singleton pregnancies. Patients in twin pregnancies may be at higher risk of delivery before administration of full antenatal corticosteroids dose, therefore require immediate management initiation and transfer to a tertiary referral centre.

Keywords: pregnancy; pregnancy outcome; premature birth; preterm premature rupture of the membranes; twin.

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Female
  • Fetal Membranes, Premature Rupture* / epidemiology
  • Fetal Membranes, Premature Rupture* / etiology
  • Fetal Membranes, Premature Rupture* / therapy
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Pregnancy
  • Pregnancy Outcome / epidemiology
  • Pregnancy, Twin*
  • Retrospective Studies
  • Watchful Waiting


  • Adrenal Cortex Hormones

Supplementary concepts

  • Preterm Premature Rupture of the Membranes