Ginecologia y obstetricia de Mexico · 2013
[Fetal complications and early neonatal outcomes on 147 triplets].
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Duyos Mateo Inmaculada, de la Calle María, Revello Rocío, Salas Patricia, Zapardiel Ignacio, González Antonio
Аннотация
BACKGROUND: During the last ten years multiple pregnancies have been increased as a result of assisted reproduction techniques, increases of even 470% are published. Multiple pregnancies are related to a higher risk of maternal and neonatal morbidity and mortality, as well as to increased use of health resources.
OBJECTIVES: To review the fetal and perinatal early complications in triple pregnancies.
PATIENTS AND METHOD: An observational and retrospective study of triple pregnancies followed up at the Obstetrics Department of La Paz University Hospital, Madrid, Spain, from January 2000 until May 2011.
RESULTS: We reviewed the medical records of 147 triplets. The prevalence of triplets was 1 in 640 deliveries (0.15%). Among all, 79% were achieved using assisted reproductive techniques, 73% were obtained by means of in vitro fertilization. Regarding the pregnancy zigosity we found: 85% trichorionic triamniotic, 10% bichorionic triamniotic and 5% monochorionic tramniotic. Out of 402 fetuses, 35 (9%) had the following complications: 19(5%) growth retardation or oligohydramnios, nine (2%) intrauterine death, three (0.74%) postnatal death due to suspected chorioamnionitis, three (0.74%) major malformations and one case (0.24%) of twin to twin transfusion. The average duration of gestation was 33 weeks: 8% were born before 28 weeks of gestation, 30% between 28 and 32 weeks and 62% after 32 weeks. The mean birth weight was 1,906 +/- 400 g. In 29 cases (7%) arterial pH was less than 7.20. Any type of resuscitation was required by 60% of newborns and 47% were admitted to the intensive care unit. There were no significant differences in neonatal early outcomes among the first, second and third newborn.
CONCLUSIONS: The risk of neonatal mortality and morbidity seems to be higher in triple pregnancies. Adverse neonatal outcomes are related to the high rate of severe prematurity.
OBJECTIVES: To review the fetal and perinatal early complications in triple pregnancies.
PATIENTS AND METHOD: An observational and retrospective study of triple pregnancies followed up at the Obstetrics Department of La Paz University Hospital, Madrid, Spain, from January 2000 until May 2011.
RESULTS: We reviewed the medical records of 147 triplets. The prevalence of triplets was 1 in 640 deliveries (0.15%). Among all, 79% were achieved using assisted reproductive techniques, 73% were obtained by means of in vitro fertilization. Regarding the pregnancy zigosity we found: 85% trichorionic triamniotic, 10% bichorionic triamniotic and 5% monochorionic tramniotic. Out of 402 fetuses, 35 (9%) had the following complications: 19(5%) growth retardation or oligohydramnios, nine (2%) intrauterine death, three (0.74%) postnatal death due to suspected chorioamnionitis, three (0.74%) major malformations and one case (0.24%) of twin to twin transfusion. The average duration of gestation was 33 weeks: 8% were born before 28 weeks of gestation, 30% between 28 and 32 weeks and 62% after 32 weeks. The mean birth weight was 1,906 +/- 400 g. In 29 cases (7%) arterial pH was less than 7.20. Any type of resuscitation was required by 60% of newborns and 47% were admitted to the intensive care unit. There were no significant differences in neonatal early outcomes among the first, second and third newborn.
CONCLUSIONS: The risk of neonatal mortality and morbidity seems to be higher in triple pregnancies. Adverse neonatal outcomes are related to the high rate of severe prematurity.