{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T11:39:37Z","timestamp":1784288377470,"version":"3.55.0"},"reference-count":18,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,4,18]],"date-time":"2023-04-18T00:00:00Z","timestamp":1681776000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Hospital Cl\u00ednic de Barcelona (Premi Fi de Resid\u00e8ncia \u201cEmili Letang- Josep Font\u201d 2020) (Spain)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Preterm prelabour rupture of membranes (PPROMs) before viability carries significant perinatal mortality and morbidity. Clinical management and prenatal counselling are a challenge, especially in twin pregnancies, due to scarce evidence on how previable PPROM affects this population. The aim of this study was to describe pregnancy outcomes of twin pregnancies complicated with previable PPROM and evaluate potential prognostic factors that may predict perinatal mortality. A retrospective cohort including dichorionic and monochorionic diamniotic twin pregnancies complicated with PPROM before 24 + 0 weeks of pregnancy was evaluated. Perinatal outcomes of pregnancies managed expectantly were described. Factors predicting perinatal mortality or reaching periviability (defined from 23 + 0 weeks onwards) were evaluated. Of the 45 patients included, 7 (15.6%) spontaneously delivered within the first 24 h after diagnosis. Two patients (5.3%) requested selective termination of the affected twin. In the 36 ongoing pregnancies that opted for expectant management, the overall survival rate was 35\/72 (48.6%). There were 25\/36 (69.4%) patients who delivered after 23 + 0 weeks of pregnancy. When periviability was achieved, neonatal survival increased up to 35\/44 (79.5%). Gestational age at delivery was the only independent risk factor of perinatal mortality. The overall survival rate of twin pregnancies complicated with previable PPROM is poor but similar to singletons. No prognostic factors, apart from achieving periviability, were identified as individual predictors of perinatal mortality.<\/jats:p>","DOI":"10.3390\/jcm12082949","type":"journal-article","created":{"date-parts":[[2023,4,19]],"date-time":"2023-04-19T01:09:22Z","timestamp":1681866562000},"page":"2949","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Preterm Prelabour Rupture of Membranes before Viability in Twin Pregnancies: What Can We Expect?"],"prefix":"10.3390","volume":"12","author":[{"given":"J\u00falia","family":"Ponce","sequence":"first","affiliation":[{"name":"BCNatal, Fetal Medicine Research Center, Hospital Cl\u00ednic and Hospital Sant Joan de D\u00e9u, 08028 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Cobo","sequence":"additional","affiliation":[{"name":"BCNatal, Fetal Medicine Research Center, Hospital Cl\u00ednic and Hospital Sant Joan de D\u00e9u, 08028 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8343-9526","authenticated-orcid":false,"given":"Clara","family":"Murillo","sequence":"additional","affiliation":[{"name":"BCNatal, Fetal Medicine Research Center, Hospital Cl\u00ednic and Hospital Sant Joan de D\u00e9u, 08028 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Gonce","sequence":"additional","affiliation":[{"name":"BCNatal, Fetal Medicine Research Center, Hospital Cl\u00ednic and Hospital Sant Joan de D\u00e9u, 08028 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Dom\u00ednguez","sequence":"additional","affiliation":[{"name":"BCNatal, Fetal Medicine Research Center, Hospital Cl\u00ednic and Hospital Sant Joan de D\u00e9u, 08028 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0140-7411","authenticated-orcid":false,"given":"Francesca","family":"Crovetto","sequence":"additional","affiliation":[{"name":"BCNatal, Fetal Medicine Research Center, Hospital Cl\u00ednic and Hospital Sant Joan de D\u00e9u, 08028 Barcelona, Spain"},{"name":"Institut de Recerca Sant Joan de D\u00e9u, 08950 Esplugues de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Guirado","sequence":"additional","affiliation":[{"name":"BCNatal, Fetal Medicine Research Center, Hospital Cl\u00ednic and Hospital Sant Joan de D\u00e9u, 08028 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Montse","family":"Palacio","sequence":"additional","affiliation":[{"name":"BCNatal, Fetal Medicine Research Center, Hospital Cl\u00ednic and Hospital Sant Joan de D\u00e9u, 08028 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3935-1935","authenticated-orcid":false,"given":"Mar","family":"Bennasar","sequence":"additional","affiliation":[{"name":"BCNatal, Fetal Medicine Research Center, Hospital Cl\u00ednic and Hospital Sant Joan de D\u00e9u, 08028 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/S0140-6736(08)60074-4","article-title":"Epidemiology and causes of preterm birth","volume":"371","author":"Goldenberg","year":"2008","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1097\/GRF.0b013e318217d60d","article-title":"Preterm premature rupture of membranes complicating twin pregnancy: Management considerations","volume":"54","author":"Sela","year":"2011","journal-title":"Clin. 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Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/8\/2949\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:18:33Z","timestamp":1760123913000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/8\/2949"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,18]]},"references-count":18,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["jcm12082949"],"URL":"https:\/\/doi.org\/10.3390\/jcm12082949","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,18]]}}}