Management of multifetal pregnancies: sixteen years' experience at the Sloan Hospital for Women.

An analysis is made of the management and outcome of 35 pregnancies involving triplets, quadruplets, and quintuplets. Bed rest does not seem to increase the gestational age at the time of delivery but definitely improves the fetal outcome. Administration of betamethasone as early as 24 to 26 weeks' gestation to enhance pulmonary maturity is recommended. Cesarean section is the best mode of delivery if the obstetrician is not confident enough with vaginal maneuvers. The rate in this series was 42%. An experienced medical and nursing staff is mandatory for the successful management of multifetal gestations.