Background Heterotopic cesarean scar pregnancy （HCSP） is a very rare but life-threatening entity and there is no optimal management strategy. Here we report a successfully managed case of HCSP with expectant treatme...Background Heterotopic cesarean scar pregnancy （HCSP） is a very rare but life-threatening entity and there is no optimal management strategy. Here we report a successfully managed case of HCSP with expectant treatment in a tertiary referral hospital. Methods A woman with HCSP after in vitro fertilization-embryo transfer opted for expectant treatment after five days of mild bleeding and ultrasound demonstrated cardiac activity disappearance of the scar pregnancy at 8＋4 weeks of gestation. Results The patient had mild to moderate bleeding during close monitoring. Three days later, speculum examination revealed the gestational mass was partly protruding at the os of the cervix and it was removed with forceps without massive hemorrhage. A healthy male baby was delivered by cesarean section at gestational age of 36＋4 weeks. Conclusions The expectant method might be an alternative option for a HCSP with loss of cardiac activity of the scar pregnancy, when applied under supportive management and with available emergency surgery facilities.展开更多
It is pointed out in this paper that the concept of scenario earthquake, expectant earthquake or proposed earthquake suggested by Kameda Nojima (1988) is not probability consistent due to unfit understanding for the ...It is pointed out in this paper that the concept of scenario earthquake, expectant earthquake or proposed earthquake suggested by Kameda Nojima (1988) is not probability consistent due to unfit understanding for the aseismic design standard of probabilistic method. The corresponding concept proposed by QI FENG LUO meets the meaning of probability consistent, but it is still in a meaning of average so the result is not good enough. On the basis of above analysis, a concept of probability consistent conservative earthquakes is suggested. And a new method selecting aseismic objective earthquake with physical meaning is proposed on the basis of probabilistic method. After seismic hazard is analysed by certain control parameters, such as peak acceleration, we can determine the aseismic standard according to certain probabilistic level. Based on the attenuation law and the potential sources, we can find out some earthquakes or their combinations of magnitudes and distances. Such earthquakes or combinations are probability consistent for this control parameter. Based on above parameter, we suggest considering the destructive effects of other parameters (such as response spectrum), and selecting conservative earthquakes to replace the average earthquake and meet the requirements of aseismic design better.展开更多
Premature Rupture of Membranes (PROM) with the resulting prematurity remains a major public health issue in the Democratic Republic of Congo (DRC). This study aimed to assess expectant management of PPROM before 34 we...Premature Rupture of Membranes (PROM) with the resulting prematurity remains a major public health issue in the Democratic Republic of Congo (DRC). This study aimed to assess expectant management of PPROM before 34 weeks at the university hospital of Kinshasa. We conducted a retrospective analysis of expectantly managed PROM before 34 weeks between January 2008 and December 2018. Maternal and fetal outcomes were collected, and all data were analyzed using the SPSS 23.0 software. Of the 113 patients included in the study, 2.6% were diagnosed with PROM before 34 weeks. We observed prolongation of the pregnancy duration;the median latency period was eight days, and the average gestational age at delivery of 32.85 ± 2.5 weeks. Chorioamnionitis (23%), severe oligoamnios (7%), and acute fetal distress (4%) were complications observed during the latency period. In the postpartum period, endometritis (6.2%), neonatal jaundice (39.8%), anemia (25.7%), ulcerative necrotizing enterocolitis (6.2%), cerebromeningeal hemorrhage (5.3%), and acute respiratory distress syndrome (4.4%) were complications observed. The risk of infection during the latency period was significantly associated with irregular (P = 0.045) or lack (P = 0.006) antenatal care (ANC) attendances and C-Reactive Protein (CRP) results 6 (P = 0.013). The risk of neonatal death was significantly associated to infection during the latency period (P = 0.011), irregular (P = 0.009) or lack of ANC (P = 0.000) attendances, Birth weight g (P = 0.039) as well as Gestational age at birth between 28 to 30 Weeks (S) (P = 0.021). These findings report first-time pregnancy outcomes related to the management of PPROM before 34 weeks in our setting. We found that the conservative attitude adopted allowed the prolongation of pregnancies, reducing the risks associated with prematurity. Nevertheless, attendance in good quality ANC could reduce the frequency of PROM and related adverse outcomes.展开更多
Background: The prevention of mother to child transmission (PMTCT) of human immunodeficiency virus (HIV) is paramount in safeguarding the lives of unborn children and young babies. The study sought to examine the know...Background: The prevention of mother to child transmission (PMTCT) of human immunodeficiency virus (HIV) is paramount in safeguarding the lives of unborn children and young babies. The study sought to examine the knowledge and attitudes of expectant mothers towards HIV screening and testing in the Jachie-Pramso Community of the Ashanti Region. Methods: The study adopted a descriptive survey approach as its research design. The population of the study comprised 158 expectant mothers who were registered and attended regular antenatal care sessions at the community hospital. The census approach to sampling was adopted for the study. A structured questionnaire was used as the tool for data collection. Chi-square and descriptive statistics were used to analyse the data. Results: The findings from the study indicated that awareness level of HIV and its related issues were high among expectant mothers. It was also found that attitude of healthcare workers, community members and sexual partners are the main factors that prevent expectant mothers from patronising voluntary counselling and testing (VCT) services. It was generally, recommended that intensive educational programmes be instituted to sensitize both healthcare workers and the general public on discriminative behaviours. Conclusion: Most of the expectant mothers have knowledge of HIV and attitudes of the expectant mothers towards VCT of HIV were positive. The healthcare facility and its professionals may consider training the expectant mothers so they can act as snow-ballers in the dissemination of relevant health education and coerce other expectant mothers in the community to participate in the VCT and HIV programmes.展开更多
Objective: To study the clinical progress, risk factors, management, and outcomes of suspected ectopic pregnancy (EP). Design: Retrospective clinical case study. Population: All 184 patients hospitalized for suspected...Objective: To study the clinical progress, risk factors, management, and outcomes of suspected ectopic pregnancy (EP). Design: Retrospective clinical case study. Population: All 184 patients hospitalized for suspected EP during the period 1.1.2008-31.12.2011. Setting: Oulu University Hospital, Finland. Methods: The clinical progress, risk factors, management, complications and outcomes were based on studies of hospital records. Main outcome measures: Symptoms, serum quantitative human chorionic gonadotropin (hCG) levels, management, complications and outcome of patients. Results: At least one of the risk factors was found in 117 women (66%). There were 11 patients without symptoms. In the initial visit, the median hCG concentration was 1915 (20 - 73,000) IU/l. The most common treatment was surgical, 137/181 (76%), followed with medical treatment, 22/181 (12%) and expectant management, 22/181 (12%). Conclusions: Surgery was the most widely used treatment for EP. We might thus draw attention to more conservative management.展开更多
Background: Anxiety and depressive disorders can disturb the development of pregnancies. The goal was to study the prevalence and factors associated with anxiety and depression in expectant mothers followed in public ...Background: Anxiety and depressive disorders can disturb the development of pregnancies. The goal was to study the prevalence and factors associated with anxiety and depression in expectant mothers followed in public maternity wards of Parakou in 2018. Population and methods: It was a cross- sectional study which consisted in an exhaustive census and a consecutive recruitment of 835 expectant mothers from June 14th to September 14th, 2018. Data collection was realized through interview between the investigator and the respondent basing on a questionnaire in which were integrated Edinburgh Postnatal Depression Scale-3 (EPDS-3), EPDS and modular Integrated Household Living Conditions Survey (IHLCS-2015) to assess respectively anxiety, depression and expectant mothers’ socio-economic level. Results: The prevalences of anxiety and depression were respectively 44.91% and 35.33%. Many factors were associated with anxiety and depression. Low socio-economic level increased 6.7 times the risk of developing anxiety (OR = 6.70;IC95% [2.83 - 13.00];p = 0.000) and 8.64 times the risk for the onset of depression (OR = 8.64;IC95% [3.09 - 17.18];p = 0.000). Celibacy increased 2.67 times the risk of developing anxiety (OR = 2.67;IC95% [1.19 - 5.98];p = 0.000) and 2.18 times the one of depression (OR = 2.18;IC95% [1.07 - 4.40];p = 0.000). Low economic level and celibacy were the main psychosocial determinants of anxiety and depression in expectant mothers. Conclusion: The implementation of multidisciplinary action program centred on improving purchasing power would reduce the risk of anxiety and depression in expectant mothers.展开更多
The preterm premature rupture of membranes occurring in early pregnancy at less than 23 - 24 weeks (prior to fetal viability), has higher risk for early preterm delivery, and therefore, the poorer the prognosis with p...The preterm premature rupture of membranes occurring in early pregnancy at less than 23 - 24 weeks (prior to fetal viability), has higher risk for early preterm delivery, and therefore, the poorer the prognosis with poor chance of neonatal survival and a high rate of severe, long-term neonatal morbidity among survivors. In such cases in absence of overt evidence of intrauterine infection at the time of diagnosis termination of pregnancy or expectant management is generally offered modality of treatment, the prior being commonly preffered. When expectant management is instituted, it is very rare that spontaneous resealing of the membranes occurs with the outcome that is equivocal to normal pregnancy. The presented case is an example of this rare happening. A 25-year-old, mangolian, primigravida at 20 weeks of pregnancy had spontaneous preterm premature rupture of membranes. After 8 days of expectant management, she had cessation of amniotic fluid leak and could continue pregnancy till term with normal feto-maternal outcome at 37 weeks of pregnancy. The risk of infection increases with prolongation of latency period but in this case, the latency period was prolonged for more than 16 weeks and there was no evidence of infection, with normal feto-maternal outcome at term. This is the first case of its kind happened in our hospital and deserves to be reported. It is expected that this article will reveal the possibility of resealing of spontaneous preterm premature rupture of membrane with proper expectant management.展开更多
The transmission capacity of Mobile Ad Hoc Networking (MANET) is constrained by the mutual interference of concurrent transmissions between nodes. First, the transmission capacity of MANET is studied by the view of in...The transmission capacity of Mobile Ad Hoc Networking (MANET) is constrained by the mutual interference of concurrent transmissions between nodes. First, the transmission capacity of MANET is studied by the view of information flow between nodes. At the same time, the problem that the interference between nodes affects the transmission capacity of MANET is also studied by the tool of the event conflict graph. Secondly, the paper presents the method to compute the maximum ex- pectant achievable capacity for the given conflict graph, and concludes and proves an sufficient con- dition that the information flow transmit successfully between nodes. At last, the results are simulated and a fitting equation of transmission capacity between nodes is given.展开更多
Ball lightning is widely concerning because it is hard to detect,predict,and reproduce.The dependences of electromagnetic(EM)solitons,which are considered expectant ball lightning,forming at the wavelength of the inci...Ball lightning is widely concerning because it is hard to detect,predict,and reproduce.The dependences of electromagnetic(EM)solitons,which are considered expectant ball lightning,forming at the wavelength of the incident light are investigated with two-dimensional particle-in-cell simulations.It shows that both the long wavelength microwave and the short wavelength laser are not suitable for producing the observed ball-lightning-like EM solitons.A strong field terahertz wave is proposed to inject and generate EM solitons.This paper can provide some references for researchers studying ball lightning.展开更多
Purpose:To explore the childbirth expectations of Chinese expectant parents during their transition to parenthood.Methods:A cross-sectional descriptive survey was used through the Chinese version of the Childbirth Exp...Purpose:To explore the childbirth expectations of Chinese expectant parents during their transition to parenthood.Methods:A cross-sectional descriptive survey was used through the Chinese version of the Childbirth Expectations Questionnaire.A total of 240 expectant parents were recruited when they were admitted to the obstetric units waiting for delivery at a large Maternal and Child Health care Center in Beijing,and 210 couples completed the questionnaires,yielding a response rate of 87.5%.Results:The expectant parents had a high level of childbirth expectations towards caregiving environment,spousal support,control and participation and medical support.Conversely,their expectations toward labor pain and their own ability to cope with the pain were relatively low.Expectant fathers’childbirth expectations and preference of partner’s accompany were two significant predictors of expectant mothers’childbirth expectations,explaining 18.9%and 3.3%of the total variance,respectively.While expectant mothers’childbirth expectations was the only significant predictor of expectant fathers’childbirth expectations.Conclusion:This study adds to understanding of the childbirth expectations of Chinese expectant parents.It is suggested that maternity healthcare providers pay close attention to the childbirth expectations of expectant parents,and improve the nursing care service to promote positive childbirth experiences and satisfaction of expectant parents.展开更多
The management of preterm prelabor rupture of membranes (PPROM) before 34 weeks of gestation is intractable, due to pulmonary immaturity, many complications, poor pregnancy outcomes. In particular, the pre-viable PPRO...The management of preterm prelabor rupture of membranes (PPROM) before 34 weeks of gestation is intractable, due to pulmonary immaturity, many complications, poor pregnancy outcomes. In particular, the pre-viable PPROM (<23 weeks of gestation) is much more difficult to be treated. The clinical recommendation is to terminate the pregnancy as soon as possible. The pregnancy outcomes of PPROM in the early second-trimester of two twin pregnant women in our hospital were reported to explore the treatment protocols. The pregnancies of the two women developed PROM at 12 and 16 weeks of gestation, respectively. After expectant treatment, they were deliveried successfully at 34+6 and 34+4 weeks of gestation, respectively. The assessment of growth and development of infants was normal during the following six months after birth. Therefore, if PPROM occurs in the early second-trimester of pregnancy, the management of PPROM should be individualized, it’s a long process which should include comprehensive communication between patients and families regarding alternative treatment options (including expectant management) and risks and benefits of the procedure. In the absence of spontaneous labor or occurrence of complications that would prompt delivery (intra-amniotic infection, abruptio placenta, cord prolapse), and fetal status is normal, the patients should proceed with expectant treatment, induction of labor is commonly performed in pregnancies with PPROM ≥34 weeks of gestation.展开更多
文摘Background Heterotopic cesarean scar pregnancy （HCSP） is a very rare but life-threatening entity and there is no optimal management strategy. Here we report a successfully managed case of HCSP with expectant treatment in a tertiary referral hospital. Methods A woman with HCSP after in vitro fertilization-embryo transfer opted for expectant treatment after five days of mild bleeding and ultrasound demonstrated cardiac activity disappearance of the scar pregnancy at 8＋4 weeks of gestation. Results The patient had mild to moderate bleeding during close monitoring. Three days later, speculum examination revealed the gestational mass was partly protruding at the os of the cervix and it was removed with forceps without massive hemorrhage. A healthy male baby was delivered by cesarean section at gestational age of 36＋4 weeks. Conclusions The expectant method might be an alternative option for a HCSP with loss of cardiac activity of the scar pregnancy, when applied under supportive management and with available emergency surgery facilities.
文摘It is pointed out in this paper that the concept of scenario earthquake, expectant earthquake or proposed earthquake suggested by Kameda Nojima (1988) is not probability consistent due to unfit understanding for the aseismic design standard of probabilistic method. The corresponding concept proposed by QI FENG LUO meets the meaning of probability consistent, but it is still in a meaning of average so the result is not good enough. On the basis of above analysis, a concept of probability consistent conservative earthquakes is suggested. And a new method selecting aseismic objective earthquake with physical meaning is proposed on the basis of probabilistic method. After seismic hazard is analysed by certain control parameters, such as peak acceleration, we can determine the aseismic standard according to certain probabilistic level. Based on the attenuation law and the potential sources, we can find out some earthquakes or their combinations of magnitudes and distances. Such earthquakes or combinations are probability consistent for this control parameter. Based on above parameter, we suggest considering the destructive effects of other parameters (such as response spectrum), and selecting conservative earthquakes to replace the average earthquake and meet the requirements of aseismic design better.
文摘Premature Rupture of Membranes (PROM) with the resulting prematurity remains a major public health issue in the Democratic Republic of Congo (DRC). This study aimed to assess expectant management of PPROM before 34 weeks at the university hospital of Kinshasa. We conducted a retrospective analysis of expectantly managed PROM before 34 weeks between January 2008 and December 2018. Maternal and fetal outcomes were collected, and all data were analyzed using the SPSS 23.0 software. Of the 113 patients included in the study, 2.6% were diagnosed with PROM before 34 weeks. We observed prolongation of the pregnancy duration;the median latency period was eight days, and the average gestational age at delivery of 32.85 ± 2.5 weeks. Chorioamnionitis (23%), severe oligoamnios (7%), and acute fetal distress (4%) were complications observed during the latency period. In the postpartum period, endometritis (6.2%), neonatal jaundice (39.8%), anemia (25.7%), ulcerative necrotizing enterocolitis (6.2%), cerebromeningeal hemorrhage (5.3%), and acute respiratory distress syndrome (4.4%) were complications observed. The risk of infection during the latency period was significantly associated with irregular (P = 0.045) or lack (P = 0.006) antenatal care (ANC) attendances and C-Reactive Protein (CRP) results 6 (P = 0.013). The risk of neonatal death was significantly associated to infection during the latency period (P = 0.011), irregular (P = 0.009) or lack of ANC (P = 0.000) attendances, Birth weight g (P = 0.039) as well as Gestational age at birth between 28 to 30 Weeks (S) (P = 0.021). These findings report first-time pregnancy outcomes related to the management of PPROM before 34 weeks in our setting. We found that the conservative attitude adopted allowed the prolongation of pregnancies, reducing the risks associated with prematurity. Nevertheless, attendance in good quality ANC could reduce the frequency of PROM and related adverse outcomes.
文摘Background: The prevention of mother to child transmission (PMTCT) of human immunodeficiency virus (HIV) is paramount in safeguarding the lives of unborn children and young babies. The study sought to examine the knowledge and attitudes of expectant mothers towards HIV screening and testing in the Jachie-Pramso Community of the Ashanti Region. Methods: The study adopted a descriptive survey approach as its research design. The population of the study comprised 158 expectant mothers who were registered and attended regular antenatal care sessions at the community hospital. The census approach to sampling was adopted for the study. A structured questionnaire was used as the tool for data collection. Chi-square and descriptive statistics were used to analyse the data. Results: The findings from the study indicated that awareness level of HIV and its related issues were high among expectant mothers. It was also found that attitude of healthcare workers, community members and sexual partners are the main factors that prevent expectant mothers from patronising voluntary counselling and testing (VCT) services. It was generally, recommended that intensive educational programmes be instituted to sensitize both healthcare workers and the general public on discriminative behaviours. Conclusion: Most of the expectant mothers have knowledge of HIV and attitudes of the expectant mothers towards VCT of HIV were positive. The healthcare facility and its professionals may consider training the expectant mothers so they can act as snow-ballers in the dissemination of relevant health education and coerce other expectant mothers in the community to participate in the VCT and HIV programmes.
文摘Objective: To study the clinical progress, risk factors, management, and outcomes of suspected ectopic pregnancy (EP). Design: Retrospective clinical case study. Population: All 184 patients hospitalized for suspected EP during the period 1.1.2008-31.12.2011. Setting: Oulu University Hospital, Finland. Methods: The clinical progress, risk factors, management, complications and outcomes were based on studies of hospital records. Main outcome measures: Symptoms, serum quantitative human chorionic gonadotropin (hCG) levels, management, complications and outcome of patients. Results: At least one of the risk factors was found in 117 women (66%). There were 11 patients without symptoms. In the initial visit, the median hCG concentration was 1915 (20 - 73,000) IU/l. The most common treatment was surgical, 137/181 (76%), followed with medical treatment, 22/181 (12%) and expectant management, 22/181 (12%). Conclusions: Surgery was the most widely used treatment for EP. We might thus draw attention to more conservative management.
文摘Background: Anxiety and depressive disorders can disturb the development of pregnancies. The goal was to study the prevalence and factors associated with anxiety and depression in expectant mothers followed in public maternity wards of Parakou in 2018. Population and methods: It was a cross- sectional study which consisted in an exhaustive census and a consecutive recruitment of 835 expectant mothers from June 14th to September 14th, 2018. Data collection was realized through interview between the investigator and the respondent basing on a questionnaire in which were integrated Edinburgh Postnatal Depression Scale-3 (EPDS-3), EPDS and modular Integrated Household Living Conditions Survey (IHLCS-2015) to assess respectively anxiety, depression and expectant mothers’ socio-economic level. Results: The prevalences of anxiety and depression were respectively 44.91% and 35.33%. Many factors were associated with anxiety and depression. Low socio-economic level increased 6.7 times the risk of developing anxiety (OR = 6.70;IC95% [2.83 - 13.00];p = 0.000) and 8.64 times the risk for the onset of depression (OR = 8.64;IC95% [3.09 - 17.18];p = 0.000). Celibacy increased 2.67 times the risk of developing anxiety (OR = 2.67;IC95% [1.19 - 5.98];p = 0.000) and 2.18 times the one of depression (OR = 2.18;IC95% [1.07 - 4.40];p = 0.000). Low economic level and celibacy were the main psychosocial determinants of anxiety and depression in expectant mothers. Conclusion: The implementation of multidisciplinary action program centred on improving purchasing power would reduce the risk of anxiety and depression in expectant mothers.
文摘The preterm premature rupture of membranes occurring in early pregnancy at less than 23 - 24 weeks (prior to fetal viability), has higher risk for early preterm delivery, and therefore, the poorer the prognosis with poor chance of neonatal survival and a high rate of severe, long-term neonatal morbidity among survivors. In such cases in absence of overt evidence of intrauterine infection at the time of diagnosis termination of pregnancy or expectant management is generally offered modality of treatment, the prior being commonly preffered. When expectant management is instituted, it is very rare that spontaneous resealing of the membranes occurs with the outcome that is equivocal to normal pregnancy. The presented case is an example of this rare happening. A 25-year-old, mangolian, primigravida at 20 weeks of pregnancy had spontaneous preterm premature rupture of membranes. After 8 days of expectant management, she had cessation of amniotic fluid leak and could continue pregnancy till term with normal feto-maternal outcome at 37 weeks of pregnancy. The risk of infection increases with prolongation of latency period but in this case, the latency period was prolonged for more than 16 weeks and there was no evidence of infection, with normal feto-maternal outcome at term. This is the first case of its kind happened in our hospital and deserves to be reported. It is expected that this article will reveal the possibility of resealing of spontaneous preterm premature rupture of membrane with proper expectant management.
文摘The transmission capacity of Mobile Ad Hoc Networking (MANET) is constrained by the mutual interference of concurrent transmissions between nodes. First, the transmission capacity of MANET is studied by the view of information flow between nodes. At the same time, the problem that the interference between nodes affects the transmission capacity of MANET is also studied by the tool of the event conflict graph. Secondly, the paper presents the method to compute the maximum ex- pectant achievable capacity for the given conflict graph, and concludes and proves an sufficient con- dition that the information flow transmit successfully between nodes. At last, the results are simulated and a fitting equation of transmission capacity between nodes is given.
基金supported by the National Natural Science Foundation of China(Nos.11874372 and 11922412)the Shanghai Rising-Star Program and Shanghai Foundation(No.2019-jmrh1-kj1)+1 种基金the Strategic Priority Research Program(B)(No.XDB16)the Youth Innovation Promotion Association CAS,and the Key Research Program of Frontier Sciences,CAS(No.ZDBS-LY-SLH018)。
文摘Ball lightning is widely concerning because it is hard to detect,predict,and reproduce.The dependences of electromagnetic(EM)solitons,which are considered expectant ball lightning,forming at the wavelength of the incident light are investigated with two-dimensional particle-in-cell simulations.It shows that both the long wavelength microwave and the short wavelength laser are not suitable for producing the observed ball-lightning-like EM solitons.A strong field terahertz wave is proposed to inject and generate EM solitons.This paper can provide some references for researchers studying ball lightning.
文摘Purpose:To explore the childbirth expectations of Chinese expectant parents during their transition to parenthood.Methods:A cross-sectional descriptive survey was used through the Chinese version of the Childbirth Expectations Questionnaire.A total of 240 expectant parents were recruited when they were admitted to the obstetric units waiting for delivery at a large Maternal and Child Health care Center in Beijing,and 210 couples completed the questionnaires,yielding a response rate of 87.5%.Results:The expectant parents had a high level of childbirth expectations towards caregiving environment,spousal support,control and participation and medical support.Conversely,their expectations toward labor pain and their own ability to cope with the pain were relatively low.Expectant fathers’childbirth expectations and preference of partner’s accompany were two significant predictors of expectant mothers’childbirth expectations,explaining 18.9%and 3.3%of the total variance,respectively.While expectant mothers’childbirth expectations was the only significant predictor of expectant fathers’childbirth expectations.Conclusion:This study adds to understanding of the childbirth expectations of Chinese expectant parents.It is suggested that maternity healthcare providers pay close attention to the childbirth expectations of expectant parents,and improve the nursing care service to promote positive childbirth experiences and satisfaction of expectant parents.
基金National Key Research and Development Program of China(No. 2018YFC1002900)National Natural Science Foundation of China(No. 81671527)。
文摘The management of preterm prelabor rupture of membranes (PPROM) before 34 weeks of gestation is intractable, due to pulmonary immaturity, many complications, poor pregnancy outcomes. In particular, the pre-viable PPROM (<23 weeks of gestation) is much more difficult to be treated. The clinical recommendation is to terminate the pregnancy as soon as possible. The pregnancy outcomes of PPROM in the early second-trimester of two twin pregnant women in our hospital were reported to explore the treatment protocols. The pregnancies of the two women developed PROM at 12 and 16 weeks of gestation, respectively. After expectant treatment, they were deliveried successfully at 34+6 and 34+4 weeks of gestation, respectively. The assessment of growth and development of infants was normal during the following six months after birth. Therefore, if PPROM occurs in the early second-trimester of pregnancy, the management of PPROM should be individualized, it’s a long process which should include comprehensive communication between patients and families regarding alternative treatment options (including expectant management) and risks and benefits of the procedure. In the absence of spontaneous labor or occurrence of complications that would prompt delivery (intra-amniotic infection, abruptio placenta, cord prolapse), and fetal status is normal, the patients should proceed with expectant treatment, induction of labor is commonly performed in pregnancies with PPROM ≥34 weeks of gestation.
