Maternal morbidity associated with triplet pregnancy

Malone, FD; Kaufman, GE; Chelmow, David; Athanassiou, Achilles; Nores, Jose; Me, D'Alton

doi:10.1016/s0002-9378(97)80527-3

Cited by 18 publications

(30 citation statements)

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“…Based on previous findings, [1][2][3]9,11,15,16 we expected that a larger fraction of women with triplet pregnancies develop PIATD, gestational thrombocytopenia, and perinatal liver dysfunction. This retrospective study was conducted to examine the following two hypotheses: (i) the majority of women with triplet pregnancies show gradual decreases in AT activity and platelet count during pregnancy; and (ii) women with reduced AT activity and/or platelet count are likely to have perinatal liver dysfunction and lactate dehydrogenase (LDH) elevation.…”

Section: Introductionmentioning

confidence: 88%

Liver dysfunction in triplet pregnancies: Relation to antenatal changes in antithrombin activity and platelet count

Nishida

Morikawa

Yamada

et al. 2014

J of Obstet and Gynaecol

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Section: Introductionmentioning

confidence: 88%

Liver dysfunction in triplet pregnancies: Relation to antenatal changes in antithrombin activity and platelet count

Nishida

Morikawa

Yamada

et al. 2014

J of Obstet and Gynaecol

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“…68 In other studies, HELLP syndrome occurred in 3.0% of twin pregnancies 62 and in 9.0-10.5% of triplet pregnancies. 69,70 Although twin pregnancies accounted for only 1.0-2.0% of all pregnancies, they accounted for 10.3-15.5% of all women with HELLP syndrome. 15,71 The platelet count was likely to decrease during pregnancy with increasing number of fetuses.…”

Section: Reason For Higher Risk Of Developing Hellp Syndrome and Aflpmentioning

confidence: 99%

Differentiation of acute fatty liver of pregnancy from syndrome of hemolysis, elevated liver enzymes and low platelet counts

Minakami

Morikawa

Yamada

et al. 2014

J of Obstet and Gynaecol

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As proposed criteria (Swansea criteria) for the diagnosis of acute fatty liver of pregnancy (AFLP) do not include antithrombin (AT) activity, diagnosis of AFLP may be delayed. The aim of this review is to underscore problems in the differential diagnosis of AFLP and the syndrome of hemolysis, elevated liver enzymes and low platelet counts (HELLP syndrome) and to facilitate prompt diagnosis of AFLP. Published works dealing with liver dysfunction in pregnancy, HELLP syndrome and AFLP were reviewed. AFLP and HELLP syndrome shared common clinical, laboratory, histological and genetic features, and differential diagnosis between them was often difficult. However, HELLP syndrome was likely to occur in patients with hypertension, but AFLP occurred often in the absence of hypertension. In addition, AFLP was exclusively associated with pregnancy‐induced antithrombin deficiency (PIATD). Approximately 50% of patients with AFLP did not have thrombocytopenia at presentation. As the Swansea criteria for AFLP did not include PIATD, diagnosis of AFLP was delayed until manifestation of life‐threatening complications; 60% of women were admitted to intensive care and 15% to a specialist liver unit. In conclusion, incorporation of AT activity of less than 65% into the diagnostic criteria for AFLP may facilitate suspicion and prompt diagnosis of AFLP, decrease uncertainty regarding the diagnosis of AFLP, and contribute to better investigation and understanding of the process leading to the development of liver dysfunction.

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“…26,27 Higher rates of cesarean delivery, 28 postpartum hemorrhage, endometritis, urinary infection, and diastisis recti are also documented. 26,27 Participants in the field observations stated that it is vital for postpartum and neonatal caregivers to be cognizant of how difficult it is for a woman to make the transition from an HOM pregnancy to the expectation that she will initiate lactogenesis and breastfeeding, pump, care for her infants, recover from pregnancy and delivery, and attend to her personal needs. The observed mothers and others 24,29 indicated how they felt during the early postpartum period: overwhelmed, unwell, sore and in pain, too weak to pick up the infants or make frequent visits to the nurseries, and "teetering on the edge" of exhaustion.…”

Section: Understanding Maternal Postpartum Health Statusmentioning

confidence: 99%

Breastfeeding Higher Order Multiples: Enhancing Support During the Postpartum Hospitalization Period

Leonard

2002

J Hum Lact

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Higher order multiple birth (HOM) families require genuine and effective support in their quest to breastfeed their infants during the postdelivery hospitalization period. Evidence suggests that the impact of current policies and care practices on HOM breastfeeding requires careful examination. Recommendations for enhanced support include evidence-based breastfeeding of multiples practices, multiples-specific breastfeeding education for HOM families and health professionals, and establishment of an HOM breastfeeding consultation network. Equally important are coordinated breastfeeding care, development of a breastfeeding plan in partnership with parents, avoidance or minimization of maternal-infants and infant-infants separations, and added assistance to parents when the infants' discharges are staggered. The recommendations are based on the author's extensive professional experience with HOM breastfeeding and the HOM literature.

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Maternal morbidity associated with triplet pregnancy

Cited by 18 publications

References 0 publications

Liver dysfunction in triplet pregnancies: Relation to antenatal changes in antithrombin activity and platelet count

Liver dysfunction in triplet pregnancies: Relation to antenatal changes in antithrombin activity and platelet count

Differentiation of acute fatty liver of pregnancy from syndrome of hemolysis, elevated liver enzymes and low platelet counts

Breastfeeding Higher Order Multiples: Enhancing Support During the Postpartum Hospitalization Period

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