Premature rupture of the membranes in a single twin gestational sac. A case report

Premature rupture of the membranes was diagnosed with ultrasound and subsequent injection of dye into the upper sac of a 15-week twin gestation. Because of a history of prolonged infertility, conservative treatment (including bed rest, antibiotics and intravaginal povidone-iodine pessaries) was given. Four weeks later the leakage of amniotic fluid stopped, and at 32 gestational weeks the patient delivered healthy twins by cesarean section. No sign of chorioamnionitis was noted clinically or histologically. It seems that in this unusual case the lower sac was acting as a tampon and at some stage prevented further escape of amniotic fluid as well as ascending infection.