Triplet Gestation- Prevention, Risks, &amp; Management Dilemmas

Blumenfeld, Z.; Abdallah, William; Onit, Sela-Guttmann; Rachel, Brook Olga

doi:10.2174/1874291200802010011

Cited by 4 publications

(6 citation statements)

References 24 publications

(143 reference statements)

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“…Multifetal gestation brings a high risk of maternal complications during pregnancy and postnatal complications for babies specially when born prematurely. The risk of preterm delivery for triplet pregnancies is approximately 90% while in twin gestations is more than 50%, compared with only 10% incidence of preterm labor in single infants [28]. Regarding RDS, the most common risk factor detected in our study was prematurity (37.7%).…”

Section: Discussionmentioning

confidence: 55%

Risk Factors of Respiratory Diseases Among Neonates in Neonatal Intensive Care Unit of Qena University Hospital, Egypt

Baseer

Mohamed

Abd-Elmawgood

2020

Annals of Global Health

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Background: Respiratory diseases in newborns are considered major causes of neonatal morbidity and mortality especially in developing countries. Its causes are diverse and require early detection and management. This study aimed for detection of the prevalence and risk factors of respiratory diseases in addition to outcome among neonates admitted in neonatal intensive care unit. Methods: Our study was a prospective observational study that was undertaken at the neonatal intensive care unit of Qena University Hospital, Egypt from July 2017 to July 2018. Demographic and clinical data of newborns and their mothers were evaluated and tabulated. Results: In this period, 312 neonates were admitted to the neonatal intensive care unit, out of them 145 suffered respiratory diseases giving a prevalence of (46.5%), and (55.9%) were males. The mean neonatal age at admission was 4.33 ± 7.19 days and mean gestational age was 34.49 ± 3.31 weeks. The most common detected respiratory diseases were respiratory distress syndrome (RDS; 49.6%), transient tachypnea of newborn (TTN; 22%), neonatal pneumonia (17.2%) and meconium aspiration syndrome (MAS; 6.21%). Premature rupture of membrane (PROM), maternal diabetes and fetal prematurity had the highest risk factors for respiratory diseases occurrence in neonates. Neonatal mortality rate was 26.2%, mainly due to hyaline membrane disease and pneumonia. Conclusion: Respiratory diseases constitute major part of total admission in neonatal intensive care unit especially RDS, TTN, pneumonia and MAS. Prematurity and maternal diabetes were the most important risk factors associated with respiratory diseases. Respiratory distress syndrome carried the highest risk of mortality and TTN carried the highest survival rate.

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Section: Discussionmentioning

confidence: 55%

Risk Factors of Respiratory Diseases Among Neonates in Neonatal Intensive Care Unit of Qena University Hospital, Egypt

Baseer

Mohamed

Abd-Elmawgood

2020

Annals of Global Health

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“…dapat untuk melahirkan per vagina, seksio sesarea, versi internal dan eksternal, dan total breech extraction. 1,14 Akan tetapi, seksio sesarea adalah rute yang disukai untuk melahirkan pasien dengan kehamilan triplet. Melahirkan pervaginal pasien triplet dihubungkan dengan meningkatnya risiko kelahiran mati, dan kematian neonatal dan infant dibandingkan dengan dilahirkan dengan seksio sesarea.…”

Section: Pemeriksaan Penunjangunclassified

“…6 Penelitian cohort multisenter di Amerika menunjukkan bahwa laju keberhasilan melahirkan per vagina hanya 16,7%, dan melahirkan pervagina dihubungkan dengan lebih tinginya risiko transfusi ibu dan neonatal ventilasi mekanik, berarti meningkatkan morbiditas neonatal. 1,14…”

Section: Pemeriksaan Penunjangunclassified

Pengelolaan Anestesi untuk Seksio Sesarea Kehamilan Triplet dengan Skor LAS Intraoperatif 6

Bisri

2021

JAOI

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Triplet (kembar tiga) dan kehamilan kembar yang lebih banyak lagi (higher multiple gestations) dihubungkan dengan peningkatan morbiditas ibu dan anak dibandingkan dengan kehamilan ganda atau kehamilan tunggal. Seksio sesarea adalah rute yang disukai untuk melahirkan pasien dengan kehamilan triplet. Seorang wanita, 31 tahun, G1P0A0 gravida aterm triplet hasil inseminasi, BB 72,5 kg, TB 168 cm, Mallampati 1, tekanan darah 130/90 mmHg, laju nadi 97x/menit, SpO2 100% dengan kanul binasal. Induksi dengan propofol 140 mg, atracurium 35 mg, intubasi dengan pipa endotrakheal no 6,5. Ventilasi mekanik dengan volume tidal 560 mL, laju nafas 12 x per menit, postive end expiratory pressure (PEEP) 5. Rumatan anestesi dengan N2O 40%, sevofluran 1-2 vol%. Analgetik fentanyl 100 ug diberikan setelah bayi lahir. Cairan RL 1500 mL, gelofusin 500 mL. Obat-obat lain: misoprostol 800 mcg perrectal, oxytocin 40 IU, methylergometrine 0,6 mg, asam traneksamat 1 gram, dextrose 40% 25 mL. Bayi ke-1 BB 2650 gr, pada jam 19.1, Apgar score 1 menit dan 5 menit 9, 10, Bayi ke-2 BB 2100 gr, Apgar score 1 menit dan 5 menit 9, 10, Bayi ke-3 BB 1900 gr, Apgar score 1 menit dan 5 menit 9, 10 lahir selang 1 menit. Tidak terjadi hipotensi, dan karena skor linear analog scale (LAS) 4-6 setelah terapi medikal maka dilakukan pengikatan uterus dengan tehnik B-Lynch suture, tidak terjadi postpartum hemorrhage, Hb postoperatif 10 g/dL, hematokrit 29%, tidak dilakukan transfusi darah. Analgetik pascabedah dengan petidin 100 mg dan dexketoprofen 100 mg dilarutkan dalam NaCl 0,9% 500 mL yang diberikan untuk 24 jam. Anesthesia Management for Caesarean Section Triplet Pregnancy with Intraoperative LAS Score 6 Abstract Triplet and higher multiple gestations associated with increase maternal and fetal morbidity compare with twin or singleton pregnancy. Caesarean section is route for delivery patient with triplet gestations. A woman, 31 years, G1P0A0 gravida aterm triplet insemination result, BW 72,5 kg, height 168 cm, Mallampati 1, blood pressure 130/90 mmHg, heart rate 97x/minute, SpO2 100% with canul binasal. Induction anesthesia with propofol 140 mg, atracurium 35 mg, intubated with endotracheal tube no 6,5. Mechanical ventilation with tidal volume 560 mL, respiratory rate 12 x per minutes, postive end expiratory pressure (PEEP) 5. Maintenance anesthesia with N2O 40%, sevoflurane 1-2 vol%. Analgetic fentanyl 100 ug given after baby delivery. Fluids with RL 1500 mL, gelofusin 500 mL. Other drugs are misoprostol 800 mcg perrectal, oxytocine 40 IU, methylergometrine 0.6 mg, tranexamic acid 1 gram, dextrose 40% 25 mL. First baby BW 2650 gr, Apgar score 1 minute and 5 minute 9, 10 at 19.21, second baby BW 2100 gr, Apgar score 1 minute and 5 minute 9, 10, third baby BW 1900 gr, Apgar score 1 minute and 5 minute 9, 10 delivered 1 minute interval. No evidence of hypotension and linear analog scale (LAS) score is 4-6 and so needed uterus binding with B-Lynch suture technique, no evidence of postpartum hemorrhage, postoperative Hb 19 g/dL, hematocrit 29%, no blood transfusion. Postoperative analgesia with petidine 100 mg and dexketoprofen 100 mg in NaCl 0,9% 500 mL for 24 hours.

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“…The (3D) sonographic body volume estimation is better parameter for reflecting the size of a twin and can assist the management, as sonographic 2D fetal weight estimation is not clinically applicable due to amorphous structures of the acardic twin [6]. In doubtful cases magnetic resonance imaging (MRI) can be offered [7].…”

Section: Introductionmentioning

confidence: 99%

Twin Reverse Arterial Perfusion (TRAP): Case Report

Adamou¹,

Yakasai²

2014

OJOG

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The twin reversed arterial perfusion (TRAP) sequence is an anomaly unique to monochorionic multiple pregnancies. It is a rare complication. We present a case of acardius anephus, which was mistaken for a live anomalous singleton fetus. A 21-year-old unbooked Primigravida was seen in labour ward with a ten hours history of labour pains. Urgent transabdominal ultrasound revealed a singleton live fetus at 30 weeks gestation with gross cystic mass lesion at the level of the abdomen and polyhydramnious. Caesarean section confirms a twin gestation with monoamniotic monochorionic single placenta. The umbilical cord of the acardiac twin was short-First twin was a live female baby, weighing 1000 g. TRAP is a rare event an early referral to feto maternal unit will improve perinatal outcome.

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Triplet Gestation- Prevention, Risks, & Management Dilemmas

Cited by 4 publications

References 24 publications

Risk Factors of Respiratory Diseases Among Neonates in Neonatal Intensive Care Unit of Qena University Hospital, Egypt

Risk Factors of Respiratory Diseases Among Neonates in Neonatal Intensive Care Unit of Qena University Hospital, Egypt

Pengelolaan Anestesi untuk Seksio Sesarea Kehamilan Triplet dengan Skor LAS Intraoperatif 6

Twin Reverse Arterial Perfusion (TRAP): Case Report

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