Antepartum management and neonatal outcome of triplet pregnancies.
METHODS
The maternal and neonatal outcome of 27 triplet and 1 quadruplet gestations was studied at the University Hospital of Verona.


RESULTS
Mean maternal age was 31.7+/-3.7 years; 24 women (85.7%) were nulliparous. Six (21.4%) patients had conceived spontaneously. Common maternal complications were: preterm labor (78.6%), anemia (57.1%), preeclampsia (25.0%). Thirteen patients (46.4%) had cervical cerclage, 21(75%) received tocolysis, 20 (71.4%) corticosteroid prophylaxis, 4 (14.3%) unfractionated heparin. All patients underwent Caesarean section with mean gestational age of 32+/-2.5 weeks and mean postoperative stay was 9 days. Three patients were treated in ICU after delivery, 1 was hysterectomized and 6 received blood transfusions. The live newborns were 80, the stillborns 5. Mean birth weight was 1,520+/-516 g (range 650-2,665), 95.0% being LBW. The following neonatal complications were observed: RDS (28.7%), cerebral hemorrhage (26.2% of II degrees and 1.2% of III degrees ), anemia (20%), PDA (12.5%), ROP (6.5%), polyglobulia (3.75%), NEC (2.5%). Mean hospitalization time was 30.6 days (range 2-132).


CONCLUSIONS
Iatrogenic multiple births are increasing as the use of assisted conception techniques expands. Gynecologists should be aware of maternal complications and neonatal outcome of triplet pregnancies and infertility management strategies should try to avoid iatrogenic multiple gestations.
Zanconato
Giovanni
G
Obstetrical Unit, Department of Maternal and Child Health, Biology and Genetics, University of Verona, Policlinico BorgoRoma, 37134 Verona, Italy. giovanni.zanconato@univr.it
Poggi
Sara
S
Ruffo
Roberta
R
Gazzoni
Alessandra
A
Padovani
Ezio Maria
EM
Franchi
Massimo
M
D000328:Adult; D000740:Anemia / Q000453:epidemiology / Q000209:etiology; D023802:Cerclage, Cervical / Q000706:statistics & numerical data; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D005865:Gestational Age; D006493:Heparin / Q000008:administration & dosage; D006760:Hospitalization; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology / Q000628:therapy; D007363:Intensive Care Units, Neonatal; D008297:Male; D011225:Pre-Eclampsia / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000209:etiology; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D047928:Premature Birth / Q000453:epidemiology / Q000209:etiology; D015145:Tocolysis / Q000706:statistics & numerical data; D014310:Triplets
D006493:Heparin