{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T11:10:07Z","timestamp":1752232207714,"version":"3.41.2"},"reference-count":25,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T00:00:00Z","timestamp":1750982400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Johns Hopkins University","award":["5K12HD103036"],"award-info":[{"award-number":["5K12HD103036"]}]},{"name":"Sage Therapeutics, Inc."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["AJP Rep"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>To compare severe maternal morbidity (SMM) and mortality after pre- or periviable prelabor rupture of membranes (pPPROM) in multiple gestation pregnancies among individuals choosing expectant management (EM) or termination of pregnancy (TOP).<\/jats:p><jats:p>A retrospective cohort study of multiple gestations with pPPROM between 140\/7 and 236\/7 at five hospitals within a large health system from 2011 to 2024. The primary outcome was SMM by the Centers for Disease Control (CDCs), 21 indicators compared between the two cohorts. Continuous outcomes were compared with Mann\u2013Whitney U tests. Chi-square\/Fisher's exact tests were used for categorical outcomes. Data was analyzed using R.<\/jats:p><jats:p>Forty-five twin and 1 triplet gestations were included (n\u2009=\u200937 EM, n\u2009=\u20099 TOP). There were no differences in gestational age at PPROM, age, race, and history of PPROM. There were no maternal deaths and no differences in chorioamnionitis, sepsis, ICU admission, blood loss, or hospital readmission. Seventy point three percent of patients undergoing EM experienced some form of maternal morbidity, and 27.0% experienced at least one CDC SMM indicator, but this was not different between groups.<\/jats:p><jats:p>One in four individuals with multiple gestations undergoing EM of pPPROM experienced at least one adverse maternal outcome by CDC criteria. There were no significant differences identified between EM and TOP, likely due to the study's limited size.<\/jats:p>","DOI":"10.1055\/a-2644-0279","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T19:21:27Z","timestamp":1751052087000},"page":"e106-e112","source":"Crossref","is-referenced-by-count":0,"title":["A Comparison of Severe Maternal Morbidity After Pre- and Periviable Premature Prelabor Rupture of Membranes in Multiple Gestations: Expectant Management versus Pregnancy Termination"],"prefix":"10.1055","volume":"15","author":[{"given":"Courtney T.","family":"Connolly","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siwei","family":"Xie","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ethan","family":"Gough","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marika A.","family":"Toscano","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland"},{"name":"Division of Maternal Fetal-Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,7,9]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"558.e1","DOI":"10.1016\/j.ajog.2021.10.036","article-title":"Maternal morbidity after preterm premature rupture of membranes at <24 weeks' gestation","volume":"226","author":"A 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