Nine consecutive multichorionic multiple gestations with early second-trimester (< or =20 weeks) preterm @entity397 of the membranes (PPROM) of the lower gestational sac were managed expectantly. Mean gestational age at PPROM was 17.5 weeks (13-20 weeks), and the mean PPROM delivery time interval was 6.2 weeks (0-11 weeks). A fetal loss of 63% (12 of 19), and a subsequent neonatal loss of 57% (4 of 7) were observed. Of the four pregnancies evolving beyond 25 weeks, three delivered before 30 weeks. The baby take-home rate was 16% (3 of 19). Histologic evidence of @entity5870 was present in 5 of 7 (71%) investigated pregnancies. Three other consecutive twin pregnancies were complicated by PPROM of the precervical gestational sac at 13 to 16 weeks of gestation (mean: 15 weeks). In the absence of clinical @entity5870 and amniotic fluid, selective feticide with @entity4337 was performed. Pregnancy was successfully prolonged beyond 33 weeks in two cases. The overall PPROM delivery time interval was 21 weeks (20-22 weeks). No neonatal losses were encountered. The baby take-home rate was 66% (2 of 3). Selective feticide of the fetus with early midtrimester PROM in the absence of maternal signs of @entity281 may improve the former unfavorable pregnancy outcome.

Selective feticide in twin pregnancies with very early preterm XXXX of membranes.

@entity281 :: ('MESH:D007239', 'Disease') :: ['infection'] @entity397 :: ('MESH:D012421', 'Disease') :: ['premature rupture'] @entity5870 :: ('MESH:D002821', 'Disease') :: ['chorioamnionitis'] @entity4337 :: ('MESH:D011189', 'Chemical') :: ['potassium chloride']
@entity397 :: (MESH:D012421,Disease) :: ['premature rupture']
