Sela Hen Y, Simpson Lynn L
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Medical Center New York, New York, USA.
Clin Obstet Gynecol. 2011 Jun;54(2):321-9. doi: 10.1097/GRF.0b013e318217d60d.
Preterm premature rupture of membranes (PPROM) is more prevalent in twin gestations and is major contributor to preterm birth. The management of PPROM in twin pregnancies does not differ significantly from that of singletons. In general, antenatal steroids, latency antibiotics, magnesium sulpfate for neuroprotection, and tocolysis are all potential interventions to consider when PPROM complicates a twin gestation. Certain circumstances, such as PPROM following an invasive procedure, at a previable gestational age, or in a monochorionic gestation, warrant special attention as the implications of PPROM and subsequent recommendations for these twin pregnancies may differ. In general, the approach to PPROM in twins should be individualized based on gestational age, and the maternal and neonatal risks of delaying delivery to prolong the pregnancy.
早产胎膜早破（PPROM）在双胎妊娠中更为常见，是早产的主要原因。双胎妊娠中PPROM的处理与单胎妊娠并无显著差异。一般来说，当PPROM合并双胎妊娠时，产前使用类固醇激素、预防性抗生素、用于神经保护的硫酸镁以及宫缩抑制剂都是可能需要考虑的干预措施。某些情况，如侵入性操作后发生的PPROM、在可存活孕周之前或单绒毛膜双胎妊娠中的PPROM，需要特别关注，因为这些双胎妊娠中PPROM的影响及后续建议可能有所不同。一般而言，双胎PPROM的处理应根据孕周以及延迟分娩以延长孕周的母婴风险进行个体化。
