Maternal and neonatal outcome of high order gestation

To study maternal and neonatal outcome of triplets, quadruplets and quintuplets gestations.

This retrospective review of 21 triplet, 3 quadruplet and 3 quintuplet deliveries between 1(st) January 1990 and 31(st) of August 2001.

Preterm labor was the most common maternal complication (96%). The 27 high order gestation resulted in 88 live births and two stillbirths. The early neonatal mortality rate for the entire group was 91, late neonatal deaths 45 and infant deaths 57. Of the 88 live born infants, 71(81%) survived to discharge. The incidence of respiratory distress syndrome was 69.3%, and mechanical ventilation was necessary also in 70% of the newborns, patent ductus arteriosus was diagnosed in 8% of cases. Intraventricular hemorrhage was diagnosed in 14% of cases. Nercotizing enterocolitis occurred in 8 cases. Neonatal sepsis was diagnosed in 24 cases (27%).

Early diagnosis, meticulous antenatal care, early hospitalization, frequent evaluation of fetal well being, delivery by cesarean section and on site availability of trained neonatologists and a highly functional intensive care unit are essential for better outcome.