title: Management of high-order multiple gestation.
abstract: High-order multiple gestation presents unique challenges to the clinician to obtain the best possible outcome. An aggressive proactive approach works best compared with a wait-and-treat strategy when complications occur. Frequent ultrasound evaluations, fetal fibronectin testing, and contraction monitoring are important diagnostic tools. Aggressive weight gain, bed rest, and relaxation techniques are important interventions. Tocolytic drugs are used to prevent preterm labor, and aggressive dosing of MgSO4, terbutaline pumps, and oral agents are advocated to treat preterm labor. Outcome is generally good with high-order multiple gestation with this management protocol.
authors.affiliation: Phoenix Perinatal Associates, a Division of Obstetrix Medical Group, 1331 N. 7th Street, Suite 275, Phoenix, AZ 85006, USA. john_elliot@obstetrix.com
authors.forename: John P
authors.initials: JP
authors.lastname: Elliott
mesh_terms: D005260:Female; D005323:Fetal Monitoring; D006801:Humans; D007746:Labor Presentation; D007743:Labor, Obstetric / Q000502:physiology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D011295:Prenatal Care / Q000379:methods*