Discordancy in Triplets

Abstract

Discordancy in twins is generally described as a weight difference between the fetuses of 15 to 25% and its prevalence in normal twin gestations is estimated at 15 to 29%. The present study was performed in order to determine the frequency of discordant newborns in uncomplicated triplet gestations. One hundred and fourteen normal triplet newborns were delivered during a period of 11 years. Their birthweight ranged from 493 to 2533 gm, with a mean of 1894.2 +/- 468.5 gm (+/- sd). In 58% of these 38 sets of triplets the difference in weight between the largest and smallest newborn was more than 15%. About a quarter of the newborns had a greater than 25% dissimilarity in their birthweights. There was no substantial fetal-fetal transfusion or difference in the Apgar scores between the discordant fetuses. It may be concluded that triplet newborns have a rate of discordancy double that of twins. Discordance per se does not necessarily mark an underlying complication of pregnancy or a bad perinatal outcome.

Triplets Across the First 5 Years: The Discordant Infant at Birth Remains at Developmental Risk

“…We postulate that the critical factor contributing to this persistent lower performance was the comparative low birth weight of the discordant infant, reflecting a poor intrauterine environment for this fetus compared with the siblings, and not any absolute weight percentile. 52 These findings have practical implications for the care of triplets and their parents in general and the need for special attention to discordant triplets in particular.…”

Doppler velocimetry in dichorionic twin pregnancies and its correlation with various fetal outcome

“…Birth weight discordance complicates more than 15% of twin pregnancies [5]. There is a higher rate of Intra uterine growth restriction in twins compared to singletons, probably caused by uteroplacental insufficiency resulting from increased metabolic demand or an abnormality involving placental implantation [6]. The neonatal mortality…”