Outpatient triplet management: a contemporary review

The antepartum management of 198 women who were delivered of triplets between 1985 and 1988 is reviewed. Women were managed with the assistance of ambulatory perinatal nursing to provide outpatient surveillance. Modified bed rest, prophylactic tocolysis, and betamethasone were liberally used and patients were hospitalized only when obstetrically indicated. The most common antepartum complication was preterm labor (66.2%) and the success of therapy with tocolytic agents is described. The mean gestational age and birth weight at delivery were 33.6 +/- 3 weeks (mean +/- SD) and 1871 +/- 555 gm, respectively. Comparison of the gestational age distribution at delivery with previous reviews demonstrates fewer deliveries less than 29 weeks' gestation and significantly more deliveries between 32 and 37 weeks' gestation. Cesarean delivery occurred in 94% of the triplets, which eliminated birth order as a factor that affects survival. The corrected perinatal survival rate was 95% in this contemporary review of outpatient triplet management and represents a major improvement in the expected outcome for triplets.