Management of Triplet Pregnancy

Abstract

Based on the outcome of 21 triplet pregnancies from Antoine Béclère Hospital, early diagnosis in the major requirement for improving rates of fetal survival in multiple pregnancies. The outcome was better in mothers with spontaneous ovulation than in those with induced ovulations. Elective cesarean section in proposed.

Guidelines for the Prevention of Multiple Pregnancy in Treatment by in Vitro Fertilization

“…Perinatal mortality among IVF twins was similar to that of all twins born in our maternity during the last five years (5.5%) [3]. In recent reports, perinatal loss of triplets is estimated to be around 10% [1,10]. In view of the abovementioned figures and because of the pathological impact of prematurity and its high social cost [14], it becomes clear that special efforts should be devoted to avoid twin and multiple pregnancies induced through assisted procreation and ovulation induction.…”

Transfusion Syndrome in a Triplet Pregnancy

“…The incidence of triplet pregnancies at Antoine Beclere Hospital is 1/1640. The rate of triplet pregnancies compared to twins is 1/25 [15].…”

“…Some authors have suggested routinely terminating these pregnancies at 36 weeks, preferably vaginally, if obstetrical facts are favourable [3,20]. Most authors advise cesarean section in triplet pregnancies [8,12,15]. This leads to a reduction in neonatal mortality and morbidity.…”

“…In our series, cesarean section was routinely performed [15]. However, in this case we decided to perform a vaginal delivery because of: 1) the presence of a single surviving fetus, 2) maternal-fetal infection, 3) the rapidity of the labour, 4) the potential risks of coagulopathy, and 5) the cephalic presentation of the surviving fetus.…”