Am J Perinatol 1998; 15(3): 149-153
DOI: 10.1055/s-2007-993916

© 1998 by Thieme Medical Publishers, Inc.

Selective Feticide in Twin Pregnancies with Very Early Preterm Premature Rupture of Membranes

Luc De Catte, Monika Laubach, Adel Bougatef, Carine Mares
  • Department of Obstetrics and Gynecology, and Neonatology, University Hospital, Vrije Universiteit Brussel, Brussels, Belgium
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Publication History

Publication Date:
04 March 2008 (online)


Nine consecutive multichorionic multiple gestations with early second-trimester (≤ 20 weeks) preterm premature rupture of the membranes (PPROM) of the lower gesta-tional sac were managed expectantly. Mean gestational age at PPROM was 17.5 weeks (13-20 weeks), and the mean PPROM delivery time interval was 6.2 weeks (0-11 weeks). A fetal loss of 63% (12 of 19), and a subsequent neonatal loss of 57% (4 of 7) were observed. Of the four pregnancies evolving beyond 25 weeks, three delivered before 30 weeks. The baby take-home rate was 16% (3 of 19). Histologic evidence of chorioamnionitis was present in 5 of 7 (71%) investigated pregnancies.

Three other consecutive twin pregnancies were complicated by PPROM of the precervical gestational sac at 13 to 16 weeks of gestation (mean: 15 weeks). In the absence of clinical chorioamnionitis and amniotic fluid, selective feticide with potassium chloride was performed. Pregnancy was successfully prolonged beyond 33 weeks in two cases. The overall PPROM delivery time interval was 21 weeks (20-22 weeks). No neonatal losses were encountered. The baby take-home rate was 66% (2 of 3).

Selective feticide of the fetus with early midtrimester PROM in the absence of maternal signs of infection may improve the former unfavorable pregnancy outcome.