Antepartum management of triplet gestations.
OBJECTIVE
We evaluated an alternative approach to the management of triplet gestations that did not include home uterine monitoring, prophylactic tocolysis, or routine antepartum hospitalization.


METHODS
Fifteen patients were managed over a 42-month period by an antepartum protocol that emphasized patient education regarding signs and symptoms of preterm labor, weekly prenatal visits after 24 weeks' gestation with cervical examination, and increased rest in an outpatient setting. Tocolytic therapy was only used for regular uterine contractions when cervical change was documented.


RESULTS
Nine of 15 (60%) patients with management in this uniform manner were delivered at > or = 35 weeks' gestation, and six patients (40%) completed 37 weeks of pregnancy. Only five patients (33%) received tocolytic therapy. The mean birth weight was 1957 +/- 488 gm, and only 19 of 45 neonates (42%) were admitted to the intensive care nursery.


CONCLUSIONS
This management scheme was effective in reducing preterm delivery and thereby optimizing perinatal outcome.
Peaceman
A M
AM
Department of Obstetrics and Gynecology, Northwestern University Medical School, Chicago, IL 60611.
Dooley
S L
SL
Tamura
R K
RK
Socol
M L
ML
D001724:Birth Weight; D036861:Delivery, Obstetric; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D007752:Obstetric Labor, Premature; D011247:Pregnancy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D011295:Prenatal Care; D014310:Triplets