For a study, researchers sought to outline the pregnancy outcomes for patients who had therapy for twin-twin transfusion syndrome but nevertheless experienced pre-viable and persistent prelabour rupture of membranes (PROM).
From April 2010 to June 2019, they performed a retrospective cohort research on women whose twin-twin transfusion syndrome-complicated pregnancies resulted in PROM after receiving fetoscopic laser photocoagulation at a single fetal clinic. Infant survival and the time between the PROM and birth were the results. At PROM, patients were divided into gestational age groups (before 26 weeks of gestation and 26 weeks or later). To further describe the results, the group of women who underwent PROM before 26 weeks of gestation was divided by the gestational age at PROM.
Of the 653 patients, 250 (or 38%) had PROM; 81 had it before 26 weeks of pregnancy, and 169 had it later. When PROM was used, the survival percentage of both twins to neonatal intensive care unit (NICU) release was 46.3% before 26 weeks of gestation compared to 76.9% after 26 weeks or later (P<.001); the survival rate of at least one twin was 61.2% and 98.5%, respectively (P<.001). At 16–19–6/7 weeks of gestation, 20–22–6/7 weeks, and 23–25–6/7 weeks of gestation, 14, 22, and 45 individuals, respectively, suffered PROM. Survival of both twins and at least one twin to NICU discharge was 25.0%, 47.4%, 52.8% (for two), and 33.3%, 47.4%, & 77.8% (for at least one). Of the 81 individuals with PROM before 26 weeks of pregnancy, 57 had a latency that lasted more than 48 hours. When delay remained longer than 48 hours in the presence of PROM before 26 weeks of gestation, overall survival increased (69.6% vs. 53.7%, respectively; P=.017). The survival of both twins to NICU release was 60.0%, 61.5%, and 60.7%, respectively, with the latency of more than 48 hours &PROM at 16-19 6/7, 20-22 6/7, & 23-25 6/7 weeks of gestation. The survival of at least one twin was 80.0%, 61.5%, and 85.7%, respectively.
After laser photocoagulation, earlier gestational age at PROM was related to longer latency but worse survival rates. Neonatal survival rates dramatically increase when PROM starts before 26 weeks of gestation and latency lasts longer than 48 hours.