{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T08:53:51Z","timestamp":1784364831339,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,3,1]],"date-time":"2018-03-01T00:00:00Z","timestamp":1519862400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Preterm premature rupture of membranes (<jats:styled-content style=\"fixed-case\">PPROM<\/jats:styled-content>) is a leading complication following fetoscopic laser coagulation (<jats:styled-content style=\"fixed-case\">FLC<\/jats:styled-content>) for twin\u2013twin transfusion syndrome (<jats:styled-content style=\"fixed-case\">TTTS<\/jats:styled-content>). Our primary objective was to describe the impact of improvements in surgical technique on survival and rate of <jats:styled-content style=\"fixed-case\">PPROM<\/jats:styled-content> over time. The secondary objective was to assess potential risk factors for <jats:styled-content style=\"fixed-case\">PPROM<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and Setting<\/jats:title><jats:p>Single\u2010centre retrospective observational study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>1092 consecutive cases of <jats:styled-content style=\"fixed-case\">TTTS<\/jats:styled-content> operated by <jats:styled-content style=\"fixed-case\">FLC<\/jats:styled-content> between 2000 and 2016, with a 6.8% rate of loss to follow up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The incidence of <jats:styled-content style=\"fixed-case\">PPROM<\/jats:styled-content> and potential risk factors were analysed using competing risks models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">PPROM<\/jats:styled-content>, neonatal survival and neurological damage at 28 days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">PPROM<\/jats:styled-content> &lt;32 weeks increased from 15 to 40% between 2000 and 2016 along with an overall improvement of perinatal outcomes: dual survival rose from 42 to 66% whereas dual losses dropped two\u2010fold, from 19 to 9%. Gestational age at surgery at &lt;17 weeks was a significant risk\u2010factor for <jats:styled-content style=\"fixed-case\">PPROM<\/jats:styled-content>, with an additional risk of 10% within the first week of surgery. Although early <jats:styled-content style=\"fixed-case\">PPROM<\/jats:styled-content> at &lt;20 weeks carried a 56% risk of miscarriage, the occurrence of <jats:styled-content style=\"fixed-case\">PPROM<\/jats:styled-content> at &gt;20 weeks did not affect survival, despite an increase in preterm birth at &lt;32 weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>With significant improvement in perinatal outcomes, possibly related to improvements in surgical technique, postoperative complications have shifted to non\u2010lethal obstetric complications such as <jats:styled-content style=\"fixed-case\">PPROM<\/jats:styled-content>, with rather reassuring postnatal outcomes, despite an increase in preterm birth and, potentially, morbidity. Early surgeries (&lt;17 weeks) are at higher risk of postoperative <jats:styled-content style=\"fixed-case\">PPROM<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Following laser\/<jats:styled-content style=\"fixed-case\">TTTS<\/jats:styled-content>, rates of <jats:styled-content style=\"fixed-case\">PPROM<\/jats:styled-content> increased with perinatal survival; surgeries at &lt;17 weeks are at highest risk.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.15147","type":"journal-article","created":{"date-parts":[[2018,1,30]],"date-time":"2018-01-30T08:16:40Z","timestamp":1517300200000},"page":"1154-1162","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":57,"title":["Preterm premature rupture of membranes is a collateral effect of improvement in perinatal outcomes following fetoscopic coagulation of chorionic vessels for twin\u2013twin transfusion syndrome: a retrospective observational study of 1092 cases"],"prefix":"10.1111","volume":"125","author":[{"given":"J","family":"Stirnemann","sequence":"first","affiliation":[{"name":"Obstetrics and Fetal Medicine H\u00f4pital Necker Enfants Malades AP\u2010HP Paris France"},{"name":"EA7328 and PACT Universit\u00e9 Paris Descartes Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Djaafri","sequence":"additional","affiliation":[{"name":"Obstetrics and Fetal Medicine H\u00f4pital Necker Enfants Malades AP\u2010HP Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Kim","sequence":"additional","affiliation":[{"name":"Obstetrics and Fetal Medicine H\u00f4pital Necker Enfants Malades AP\u2010HP Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I","family":"Mediouni","sequence":"additional","affiliation":[{"name":"Obstetrics and Fetal Medicine H\u00f4pital Necker Enfants Malades AP\u2010HP Paris 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