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Planned abdominal compared with planned vaginal birth in triplet pregnancies
H I Wildschut1, J van Roosmalen, E van Leeuwen
1Department of Obstetrics, Leiden University Hospital, The Netherlands.
Objective:
To compare a policy of planned abdominal delivery with a policy of planned vaginal delivery in triplet pregnancies.
Design:
Retrospective study.
Setting:
Two Dutch university hospitals, each having a different approach to the planned mode of delivery in triplet gestations.
Subjects:
Thirty women giving birth to triplets in the hospital in Leiden, who favoured planned abdominal delivery, compared with 39 from the Medical Centre in Amsterdam who favoured vaginal delivery.
Main Outcome Measures:
Perinatal mortality and early neonatal complications.
Results:
Both centres were equally successful in achieving their planned policies: in Leiden 80% of women were delivered by caesarean section but in Amsterdam 87% of women were delivered vaginally. Compared with vaginal delivery, planned abdominal delivery was associated with a significantly higher perinatal mortality rate (P = 0.02), primarily due to respiratory distress syndrome, and a higher recorded neonatal complication rate (P = 0.03), especially sepsis, respiratory distress syndrome, and necrotising enterocolitis.
Conclusions:
A policy of planned abdominal delivery in triplets is not superior to a policy of planned vaginal delivery in terms of fetal and early neonatal outcome.