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Triplet pregnancies

H Michlewitz, J Kennedy, C Kawada

    The Journal of Reproductive Medicine
    |May 1, 1981
    PubMed
    Summary
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    Triplet gestations show improved survival rates compared to historical data. However, the third infant in a set faces higher mortality and morbidity risks, suggesting cesarean delivery may be beneficial.

    Area of Science:

    • Perinatology
    • Maternal-Fetal Medicine
    • Neonatology

    Background:

    • Triplet gestations present significant risks for both mother and neonates.
    • Historically, high rates of morbidity and mortality have been associated with multiple births, particularly triplets.

    Purpose of the Study:

    • To review outcomes of triplet gestations over a 23-year period.
    • To compare observed mortality and morbidity rates with existing literature.
    • To explore potential delivery strategies to mitigate risks in triplet pregnancies.

    Main Methods:

    • Retrospective review of 15 triplet gestations delivered between 1954 and 1977.
    • Analysis of mortality and morbidity rates based on gestational age and infant position within the set.
    • Comparison of findings with published data on triplet gestation outcomes.
    Keywords:
    Age FactorsAmericasDemographic FactorsDeveloped CountriesFetal DeathInfantInfant MortalityInfant, PrematureMorbidityMortalityNeonatal MortalityNorth AmericaNorthern AmericaPopulationPopulation CharacteristicsPopulation DynamicsPregnancyPregnancy, MultipleReproductionUnited StatesYouth

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    Main Results:

    • Overall mortality rate for triplet gestations of 28 weeks or more was 7.1%, which is favorable compared to literature rates (15-50%).
    • The third infant in a triplet set exhibited a 14.3% mortality rate, consistent with higher reported risks.
    • Elevated morbidity was observed in triplet gestations; vaginal delivery of the third infant was associated with increased risks.

    Conclusions:

    • While overall survival in triplet gestations has improved, specific risks remain, particularly for the third infant.
    • The findings suggest that a more liberal approach to cesarean section for the third infant may reduce neonatal risks.
    • Further research is needed to establish optimal delivery methods for triplet pregnancies to minimize adverse outcomes.