Management and outcome of triplet gestations: A retrospective review

J. Francis, Craig Towers, M. Porto, D. C. Lagrnv

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To describe the perinatal outcome and use of home uterine activity monitoring (HUAM) in a cohort of triplets whose prenatal care was managed by a single university affiliated perinatology group based at three hospitals. STUDY DESIGN: Retrospective chart review of triplet pregnancies reaching 20 weeks gestation from January 1990 to April 1996. Categoric variables were compared by X2 analysis and Fisher's exact test when appropriate. RESULTS: 65 triplet gestations were included, 57 from assisted reproductive techniques and 8 spontaneous. HUAM was instituted at 22 weeks based on individual physician preference or patient insistence. Overall mean and median gestational ages (GA) at delivery were 33.7 and 34.1 weeks respectively. There was no difference in delivery GA between patients with HUAM vs. those without, 33.3 and 34.0 weeks respectively. 2/35 (6%) of HUAM patients vs 4/30 (13%) without HUAM delivered from preterm labor (PTL) with failed tocolysis (NS) at <35 weeks. 1 patient (no HUAM) delivered with PTL after refusing tocolysis. Overall, mean birth weight was 1947 gms. 33/195 neonates (17%) were <1500 gms. There were 5 perinatal deaths (perinatal mortality rate 25/1000), 2 from prematurity complications after PPROM, 1 unexplained stillbirth in PTL after PPROM, 1 lethal anomaly, and one from twin-twin transfusion syndrome. There was no difference in the incidence of serious morbidity in neonates born from HUAM monitored gestations vs. those without (11% vs 13%, NS). There was no difference in the proportion of pregnancies with any serious neonatal morbidity in HUAM monitored gestations vs. those without (26% vs 17%, NS). The overall incidence of PTL, defined as régulai1 uterine contractions with cervical change at <35 weeks, was 23% (15/65). CONCLUSIONS: Although the study of management interventions in triplet gestations remains iimited by sample si/e, we were able to demonstrate good outcomes in 65 sets of triplets, comparable to those recently reported in the literature. We were unable to demonstrate a difference in PTD from PTL, gestational age at delivery, or serious neonatal morbidity in patients managed with HUAM vs. those without.

Original languageEnglish (US)
JournalActa Diabetologica Latina
Volume176
Issue number1 PART II
StatePublished - Dec 1 1997

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Uterine Monitoring
Premature Obstetric Labor
Pregnancy
Tocolysis
Gestational Age
Morbidity
Triplet Pregnancy
Perinatology
Newborn Infant
Fetofetal Transfusion
Uterine Contraction
Assisted Reproductive Techniques
Prenatal Care
Stillbirth
Patient Preference
Perinatal Mortality
Incidence
Birth Weight

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Management and outcome of triplet gestations : A retrospective review. / Francis, J.; Towers, Craig; Porto, M.; Lagrnv, D. C.

In: Acta Diabetologica Latina, Vol. 176, No. 1 PART II, 01.12.1997.

Research output: Contribution to journalArticle

Francis, J, Towers, C, Porto, M & Lagrnv, DC 1997, 'Management and outcome of triplet gestations: A retrospective review', Acta Diabetologica Latina, vol. 176, no. 1 PART II.
Francis, J. ; Towers, Craig ; Porto, M. ; Lagrnv, D. C. / Management and outcome of triplet gestations : A retrospective review. In: Acta Diabetologica Latina. 1997 ; Vol. 176, No. 1 PART II.
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N2 - OBJECTIVE: To describe the perinatal outcome and use of home uterine activity monitoring (HUAM) in a cohort of triplets whose prenatal care was managed by a single university affiliated perinatology group based at three hospitals. STUDY DESIGN: Retrospective chart review of triplet pregnancies reaching 20 weeks gestation from January 1990 to April 1996. Categoric variables were compared by X2 analysis and Fisher's exact test when appropriate. RESULTS: 65 triplet gestations were included, 57 from assisted reproductive techniques and 8 spontaneous. HUAM was instituted at 22 weeks based on individual physician preference or patient insistence. Overall mean and median gestational ages (GA) at delivery were 33.7 and 34.1 weeks respectively. There was no difference in delivery GA between patients with HUAM vs. those without, 33.3 and 34.0 weeks respectively. 2/35 (6%) of HUAM patients vs 4/30 (13%) without HUAM delivered from preterm labor (PTL) with failed tocolysis (NS) at <35 weeks. 1 patient (no HUAM) delivered with PTL after refusing tocolysis. Overall, mean birth weight was 1947 gms. 33/195 neonates (17%) were <1500 gms. There were 5 perinatal deaths (perinatal mortality rate 25/1000), 2 from prematurity complications after PPROM, 1 unexplained stillbirth in PTL after PPROM, 1 lethal anomaly, and one from twin-twin transfusion syndrome. There was no difference in the incidence of serious morbidity in neonates born from HUAM monitored gestations vs. those without (11% vs 13%, NS). There was no difference in the proportion of pregnancies with any serious neonatal morbidity in HUAM monitored gestations vs. those without (26% vs 17%, NS). The overall incidence of PTL, defined as régulai1 uterine contractions with cervical change at <35 weeks, was 23% (15/65). CONCLUSIONS: Although the study of management interventions in triplet gestations remains iimited by sample si/e, we were able to demonstrate good outcomes in 65 sets of triplets, comparable to those recently reported in the literature. We were unable to demonstrate a difference in PTD from PTL, gestational age at delivery, or serious neonatal morbidity in patients managed with HUAM vs. those without.

AB - OBJECTIVE: To describe the perinatal outcome and use of home uterine activity monitoring (HUAM) in a cohort of triplets whose prenatal care was managed by a single university affiliated perinatology group based at three hospitals. STUDY DESIGN: Retrospective chart review of triplet pregnancies reaching 20 weeks gestation from January 1990 to April 1996. Categoric variables were compared by X2 analysis and Fisher's exact test when appropriate. RESULTS: 65 triplet gestations were included, 57 from assisted reproductive techniques and 8 spontaneous. HUAM was instituted at 22 weeks based on individual physician preference or patient insistence. Overall mean and median gestational ages (GA) at delivery were 33.7 and 34.1 weeks respectively. There was no difference in delivery GA between patients with HUAM vs. those without, 33.3 and 34.0 weeks respectively. 2/35 (6%) of HUAM patients vs 4/30 (13%) without HUAM delivered from preterm labor (PTL) with failed tocolysis (NS) at <35 weeks. 1 patient (no HUAM) delivered with PTL after refusing tocolysis. Overall, mean birth weight was 1947 gms. 33/195 neonates (17%) were <1500 gms. There were 5 perinatal deaths (perinatal mortality rate 25/1000), 2 from prematurity complications after PPROM, 1 unexplained stillbirth in PTL after PPROM, 1 lethal anomaly, and one from twin-twin transfusion syndrome. There was no difference in the incidence of serious morbidity in neonates born from HUAM monitored gestations vs. those without (11% vs 13%, NS). There was no difference in the proportion of pregnancies with any serious neonatal morbidity in HUAM monitored gestations vs. those without (26% vs 17%, NS). The overall incidence of PTL, defined as régulai1 uterine contractions with cervical change at <35 weeks, was 23% (15/65). CONCLUSIONS: Although the study of management interventions in triplet gestations remains iimited by sample si/e, we were able to demonstrate good outcomes in 65 sets of triplets, comparable to those recently reported in the literature. We were unable to demonstrate a difference in PTD from PTL, gestational age at delivery, or serious neonatal morbidity in patients managed with HUAM vs. those without.

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