[Prolongation of a bi-amniotic twin pregnancy after premature rupture of fetal membranes and umbilical cord prolapse of the first twin during the 23rd week of pregnancy].

A 41-year old woman had a premature rupture of the membranes of the first twin with prolapse of the umbilical cord and the left foot in the 24th gestational week (23 + 4). The treatment consisted of bed rest in the Trendelenburg position, antibiotic prophylaxis and glucocorticoids for lung maturation. After 7 days the first twin was delivered vaginally from breech position. He died 10 hours later due to intraventricular hemorrhage. Tocolysis was administered and the umbilical cord was ligated and cut as high as possible. Seven days later a premature rupture of the membranes of the second twin and a prolapse of the fetal hand occurred. The second twin (birth weight 750 g) was delivered by cesarean section in the 26th gestational week (25 + 4) and survived without neurologic sequelae. Prolongation of pregnancy after a very premature delivery of the first twin of a biamniotic twin pregnancy can improve the neonatal outcome.