Abstract
Objective This study aims to determine if antibiotics given for latency to women with twins
and previable preterm premature rupture of membranes (PPROM) affect the duration from
membrane rupture to delivery.
Methods A retrospective cohort study of twin pregnancies at a single center from 2000 to
2015 with previable (14 0/7–22 6/7 weeks) PPROM was conducted. Women who were not candidates for expectant management
or who elected for immediate delivery were excluded. Pregnancy complications, delivery
data, and neonatal outcomes were compared between women who did and did not receive
latency antibiotics. The primary outcome was latency.
Results Of 52 eligible women, 30 (64%) elected expectant management; 17 women received antibiotics
and 13 did not. No demographic differences existed between the groups. The median
gestational age of rupture was 20 and 20.3 weeks in the antibiotic group and no antibiotic
group, respectively. Median latency was 0.8 and 2.4 weeks in the antibiotic and no
antibiotic groups correspondingly (p = 0.21). Overall, 58.8 and 23.1% of women who did and didn't receive antibiotics
developed chorioamnionitis (p = 0.07). Perinatal mortality and maternal complication rates were high, though not
different between the groups.
Conclusion Currently, even though in singletons with previable PPROM there is a recommendation
to consider administrating antibiotics, in the setting of twins, no evidence exists
to support this.
Keywords
multiple gestation - PPROM - previable preterm premature rupture of membranes - twins
