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Maternal and neonatal outcomes of 73 triplet pregnancies cared for in a dedicated multidisciplinary multiple pregnancy service at a tertiary referral unit
  1. TO Adedipe,
  2. RD Krishnan,
  3. L Bricker,
  4. JP Neilsen
  1. Liverpool Women's Hospital, Liverpool, UK

Abstract

Background Multiple pregnancies are high risk for both mother and fetus, and the risk increases as the number of fetuses increases.

Objectives To study the outcome of 73 consecutive triplet pregnancies cared for in a dedicated multidisciplinary multiple pregnancy service.

Methods Retrospective study of triplet pregnancies delivering in a 10 year period (1998–2009). Case notes and computer records were reviewed.

Results 63% were spontaneous conceptions. At least one maternal antenatal complication was noted in 50% of the study group (most commonly antepartum haemorrhage, hypertensive disorder of pregnancy and anaemia). Preterm labour occurred in 40%. Elective and emergency caesarean section rates were 51%, 38%, respectively. 11% delivered vaginally. 37% had postpartum haemorrhage, 10% required transfusion. There were no peripartum hysterectomies, intensive trauma unit admissions or maternal deaths. There were 7 intrauterine deaths (4 early and 3 stillbirths). Mean gestation at delivery was 32+ weeks (range 23–36), and the mean birth weight was 1592 g (range 150–2975). Intrauterine growth restriction occurred in 4.5%. The majority of babies were admitted to special care baby unit; median neonatal unit stay was 19 days (range 0–167). Neonatal complications included: abnormal cranial ultrasound 7.5%, respiratory distress syndrome 19%, laser treatment for retinopathy of prematurity 1.5%, neonatal death 8%. All neonatal deaths occurred in babies born before 28 weeks and weighing less than 1000 g. The congenital anomaly rate was 5%. The perinatal mortality was 9.5%.

Conclusion Our outcomes compare favourably with internationally derived data. The risk of maternal and perinatal complications is high and this justifies care in specialist centres.

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