Micheletti T, Eixarch E, Bennasar M, et al. - Researchers investigated risk factors for and outcomes after preterm prelabor rupture of membranes (PPROM) following cord occlusion (CO) in monochorionic diamniotic (MCDA) pregnancies. In this retrospective cohort study, they assessed 188 consecutive MCDA pregnancies that were managed using bipolar or laser CO, either primarily because of discordant malformation (dMF) or severe selective fetal growth restriction (sFGR), or secondarily when complete bichorionization was not possible in case of twin-to-twin transfusion syndrome (TTTS) or sFGR. Among these pregnancies, 21.3% (n = 40) had occurrence of PROM < 32 weeks, which resulted in worse perinatal outcomes, as preterm birth < 32 weeks occurred in 80.7% (vs 8.3%), procedure-to-delivery interval was 47.5 days (vs. 125), gestational age (GA) at birth 30.0 weeks (vs 37.7 weeks), and survival 65.0% (vs 91.1%). Overall findings suggest that the risk of preterm delivery increases in correlation with PROM < 32 weeks after CO. In this cohort, greater likelihood of the membrane rupture was observed when CO was performed in the context of TTTS.