Multifetal gestation--maternal and perinatal outcome of 112 pregnancies.
OBJECTIVE
Multifetal pregnancy reduction is a widespread "therapy" to diminish the risk of prematurity and adverse outcome for the survivors in higher order multiple gestation. The aim of our study was to determine the maternal and neonatal outcome of multifetal pregnancies under a conservative pregnancy management.


METHODS
A retrospective review of 112 multifetal pregnancies is presented. All higher order multiple pregnancies delivered after 25 weeks of gestation and managed at a single institution between 1982 and 1999 are included.


RESULTS
Triplets, quadruplets and quintuplets were delivered at a mean gestational age of 31 + 5, 29 + 5 and 28 + 4 weeks, respectively. The perinatal mortality was 14 for triplets and 36 for quadruplets. No quintuplet died in the perinatal period. Respiratory distress syndrome occurred in 23% of triplets, 65% of quadruplets and 75% of quintuplets, intracranial hemorrhage was diagnosed in 14% of triplets, 15% of quadruplets and 10% of quintuplets and retinopathy of prematurity was found in 10% of triplets, 9% of quadruplets and 25% of quintuplets.


CONCLUSIONS
Despite a low neonatal mortality, morbidity of higher order multiple gestations remains significant. Mortality and morbidity are related to preterm delivery but do not exceed the rates of singletons or twins of an identical gestational age. Favorable prognostic landmarks are a gestational age >30 weeks and a number of fetuses per pregnancy < or =4.


CONCLUSIONS
The risks of multifetal pregnancies are significant. Therefore, evidence-based counseling of couples seeking treatment for infertility and prevention of higher order multiple pregnancies through the prudent use of reproductive techniques attains paramount importance.
Strauss
Alexander
A
Department of Obstetrics and Gynecology-Grosshadern, University Hospital, University of Munich, Marchioninistrasse 15, D-81377 Munich, Germany. Alexander.Strauss@helios.med.uni-muenchen.de
Paek
Bettina W
BW
Genzel-Boroviczény
Orsolya
O
Schulze
Andreas
A
Janssen
Udo
U
Hepp
Hermann
H
D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007743:Labor, Obstetric; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality*; D011256:Pregnancy Outcome; D018607:Pregnancy Reduction, Multifetal; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data*; D011295:Prenatal Care; D011783:Quadruplets / Q000706:statistics & numerical data; D011811:Quintuplets / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D014310:Triplets / Q000706:statistics & numerical data