Neonatal outcomes in triplet gestations after a trial of labor.
OBJECTIVE
This study aimed to compare neonatal outcomes in a cohort of triplet gestations undergoing a trial of labor with those of a similar cohort delivered by elective cesarean delivery.


METHODS
Thirty-three women with triplet gestations who underwent a trial of labor were compared with a matched cohort of 33 women with triplet gestations who were delivered of their infants by elective cesarean delivery. Neonatal outcomes assessed included respiratory distress syndrome, retinopathy of prematurity, necrotizing enterocolitis, intraventricular hemorrhage, Apgar scores, and birth trauma.


RESULTS
Twenty-nine of 33 women (87.9%) who underwent a trial of labor had a successful vaginal delivery of all 3 neonates. One patient was delivered of her first triplet vaginally but then required a cesarean delivery for abruptio placentae; 3 other patients were delivered of their infants by cesarean section for active-phase arrest of labor. There were no differences in neonatal outcomes between the 2 groups, although triplet neonates delivered by elective cesarean section demonstrated a trend toward a greater incidence of respiratory distress syndrome (P = .09).


CONCLUSIONS
Our experience suggests that offering vaginal delivery is an acceptable management plan for triplet gestations.
Grobman
W A
WA
Department of Obstetrics and Gynecology, Northwestern University Medical School, and Northwestern Memorial Hospital, Chicago, Illinois, USA.
Peaceman
A M
AM
Haney
E I
EI
Silver
R K
RK
MacGregor
S N
SN
D000328:Adult; D001034:Apgar Score; D001720:Birth Injuries / Q000453:epidemiology; D002543:Cerebral Hemorrhage / Q000453:epidemiology; D002585:Cesarean Section; D015331:Cohort Studies; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology; D005260:Female; D005312:Fetal Blood; D005865:Gestational Age; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology; D012178:Retinopathy of Prematurity / Q000453:epidemiology; D014219:Trial of Labor; D014310:Triplets