关键词: 妊娠，双胎, 胎膜早破, 妊娠减少，多胎, 环扎术，宫颈, 治疗

Abstract:

In clinical practice, the treatment success rate of preterm premature rupture of membrane (PPROM) in twin pregnancy is very low. Once it is complicated with cervical insufficiency, the treatment becomes even more difficult. A case of a pregnant woman with dichorionic diamniotic twins who experienced PPROM in one fetus at 16⁺⁶ weeks of gestation is reported. After anti-infection and uterine contraction inhibition treatment, selective fetal reduction was performed when the condition was stable, enabling the fetus with intact membranes to continue to survive. Nine days after the operation (at 19⁺¹ weeks of gestation), cervical insufficiency occurred, and an emergency cervical cerclage was carried out, successfully prolonging the pregnancy. At term, the pregnant woman planned a vaginal delivery, but fetal heart rate deceleration occurred during the process, and a cesarean section was then performed, resulting in the smooth delivery of a healthy newborn. This case suggests that for twin pregnancies complicated with PPROM and cervical insufficiency, selective fetal reduction combined with emergency cervical cerclage may be an effective treatment method under specific circumstances, providing a reference for the clinical diagnosis and treatment of related diseases.

Key words: Pregnancy, twin, Fetal membranes, premature rupture, Pregnancy reduction, multifetal, Cerclage, cervical, Therapy