Aims and Objectives To assess the neonatal outcome of multifetal pregnancies that are complicated by Extremely Preterm Prelabour Rupture of Membranes (EPPROM) under 24 weeks of gestation.

To assess antenatal, and postnatal morbidity for both mothers and babies.

Study design The following is a retrospective observational study of twins and triplets who were referred to the Centre for Fetal Care (CFC) at Queen Charlotte’s and Chelsea Hospital (QCCH) who had an antenatal diagnosis of spontaneous EPPROM under completed 24 weeks of gestation. The population were subdivided in to the following three groups: monochorionic, dichorionic, and trichorionic. The scan data base, the obstetrics and the neonatal records of 52 women and their 108 fetuses, were the sources of the information. Our study covered a 10 year period (2002–2012), and then result was analysed

Results The median gestation at PPROM was 22 + 5 weeks (range 13–23 + 6). The latency period Median was 10 days (range 1–91 days), while the mean gestational age at delivery was 25 + 2 weeks (range 18–37) and the median fetal weight was 630 g (range 290–3500 g), pregnancy loss of 33.3% and neonatal of 29.63%. The overall survival rate was 36.11% (39 fetuses).

Conclusion Neonatal survival in EPPROM is very poor (36.11%), comer in male fetuses who had worse outcome in terms of prematurity complications and perinatal/neonatal survival.

MCDA twins had worse outcome than DCDA, in terms of antenatal complications and survival (36.36% v 72.97%).

The optimal management with EPPROM before viability remains controversial and guideline are lacking