Spontanpartus von gesunden Zwillingen in der 39. SSW nach vorzeitigem Blasensprung in der 19. SSW bei Drillingsgravidität, Extraktion des führenden toten Feten und anschließender Cerclage

Preterm premature rupture of membranes (PPROM) often complicates multifetal pregnancies and may lead to pregnancy loss or premature delivery. We report the longest so far known prolongation of a multifetal pregnancy after preterm premature rupture of membranes in the second trimester. A 32-year-old primigravida who had undergone IVF-treatment presented at 18 + 2 weeks of gestation with preterm premature rupture of membranes and umbilical cord prolapse. After intrauterine death of the first fetus extraction of the first triplet and cervical cerclage were performed. The mother was treated with bedrest, antibiotics and tocolysis. After 89 days of i.v. tocolysis and subsequent oral tocolysis, the mother was discharged from the hospital at 34 weeks of gestation. After removal of the cervical cerclage at 37 weeks of gestation two healthy fetuses were delivered vaginally at 38 weeks of gestation. The pregnancy was prolonged for 144 days after PPROM and 141 days after delivery of the first fetus. This is the longest continuation of pregnancy after PPROM described in the literature so far.