{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:16:32Z","timestamp":1753892192718,"version":"3.41.2"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T00:00:00Z","timestamp":1732579200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Preterm birth is a significant concern in multiple pregnancies, warranting effective strategies to improve outcomes. Delaying delivery of the second fetus is crucial for reducing perinatal mortality rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Presentation<\/jats:title><jats:p>In a dichorionic diamniotic twin pregnancy, one fetus experienced premature rupture of membranes (PROM) at 16+6 weeks gestation. Proactive fetal reduction through potassium chloride injection and emergency cervical cerclage at 19+1 week successfully extended the pregnancy to 39+5 weeks, resulting in a notable 160-day prolongation. Postoperative management encompassed comprehensive tocolytic therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The combined approach of proactive fetal reduction and emergency cervical cerclage proved successful in managing PROM in dichorionic diamniotic twin pregnancies. This innovative strategy offers a promising clinical solution for optimizing outcomes and prolonging gestation in high-risk multiple pregnancies, underscoring the importance of tailored interventions in complex obstetric scenarios.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fphys.2024.1489780","type":"journal-article","created":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T06:28:23Z","timestamp":1732602503000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Optimal management strategies for promoting gestational extension in dichorionic diamniotic twin pregnancies"],"prefix":"10.3389","volume":"15","author":[{"given":"Caixia","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Changyou","family":"Fan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bufei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ping","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,11,26]]},"reference":[{"key":"B1","first-page":"435","article-title":"Double pregnancy; report of a case with thirty-five days between deliveries","volume":"9","author":"Abrams","year":"1957","journal-title":"Obstetrics Gynecol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1118","DOI":"10.1097\/01.AOG.0000446856.51061.3e","article-title":"ACOG Practice Bulletin No. 144: multifetal gestations: twin, triplet, and higher-order multifetal pregnancies","volume":"123","year":"2014","journal-title":"Obstetrics Gynecol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"e155","DOI":"10.1097\/AOG.0000000000001711","article-title":"Practice bulletin No. 171: management of preterm labor","volume":"128","year":"2016","journal-title":"Obstetrics Gynecol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"154.e1","DOI":"10.1016\/j.ajog.2008.08.046","article-title":"Delayed-interval delivery in twin and triplet pregnancies: 17 years of experience in 1 perinatal center","volume":"200","author":"Arabin","year":"2009","journal-title":"Am. 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