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Mode of Delivery in Multiple Birth of Higher Order

Published online by Cambridge University Press:  01 August 2014

M. Feingold ,
C. Cetrulo ,
M. Peters ,
A. Chaudhury ,
S. Shmoys  and
O. Geifman
M. Feingold*
Affiliation:
Department of Maternal Fetal Medicine, Tufts University School of Medicine, St. Margaret's Hospital for Women, Boston, Massachusetts, USA
C. Cetrulo
Affiliation:
Department of Maternal Fetal Medicine, Tufts University School of Medicine, St. Margaret's Hospital for Women, Boston, Massachusetts, USA
M. Peters
Affiliation:
Department of Maternal Fetal Medicine, Tufts University School of Medicine, St. Margaret's Hospital for Women, Boston, Massachusetts, USA
A. Chaudhury
Affiliation:
Department of Maternal Fetal Medicine, Tufts University School of Medicine, St. Margaret's Hospital for Women, Boston, Massachusetts, USA
S. Shmoys
Affiliation:
Department of Maternal Fetal Medicine, Tufts University School of Medicine, St. Margaret's Hospital for Women, Boston, Massachusetts, USA
O. Geifman
Affiliation:
Department of Maternal Fetal Medicine, Tufts University School of Medicine, St. Margaret's Hospital for Women, Boston, Massachusetts, USA
*
Maternal Fetal Medicine, St. Margaret's Hospital, 90 Cushing Ave., Boston, MA 02125, USA

Abstract

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A retrospective review of triplets delivered at a Boston perinatal center from 1977 to 1986 was performed. Comparison was made between this group (study group) and previously published data on triplets in our institution (control group). Since 1977 there was a more liberal use of abdominal delivery. Cesarean sections (CS) of all triplets with malpresentation was our protocol. Of the 15 sets of triplet pregnancies in the study group, 11 were delivered by CS and 4 by vaginal delivery, vs only 1 CS in the control group wich consisted also of 15 triplets. The corrected mortality rate in the study group was lower than in the control group (2.6% vs 7.1%) but did not reach statistical significance. Apgar scores at 1 and 5 minutes were significantly higher in the study group (P < 0.002). Apgar scores for the third triplet were also higher in the study group (P < 0.05). In comparing the combined mortality and morbidity between the study group and the control group, no difference was found in the first triplet, but those of the second and third triplets were significantly lower in the study group. Of interest is the finding that the combined mortality and morbidity was not different statistically among the first, second, and third triplets in the study group, while in the control group an increase from the first to the third triplet was noted (21%, 31%, and 43%, respectively). A more liberal approach toward abdominal delivery of pregnancies of higher fetal number is advocated.

Keywords

TripletsCesarean sectionNeonatal mortality
Type
Research Article
Information
Acta geneticae medicae et gemellologiae: twin research , Volume 37 , Issue 1 , January 1988 , pp. 105 - 109
Copyright
Copyright © The International Society for Twin Studies 1988

References

REFERENCES

1.Belendorg, G, Breckwold, M, Neale, Ch (1970): Clinical Application of Human Gonadotropins. Stuttgart: Thieme, p 4.Google Scholar
2.Camilleri, AP (1963): In defence of the second twin. J Obstet Gynecol Br Commonw 70:258–261.CrossRefGoogle Scholar
3.Daw, E (1974): Triplet pregnancy. Br J Obstet Gynaecol 85:505–509.Google Scholar
4.Deale, CJC, Cronje, HS (1984): A review of 367 triplet pregnancies. S Afr Med J 66:92–94.Google Scholar
5.Emerich, J, Rogoza, Z, Sylwesttrowicz, W (1974): Developmental defects and mortality rate of fetuses and newborn from multiple pregnancies. Acta Genet Med Gemellol (Suppl) 22:20–25.Google Scholar
6.Holcberg, G, Biale, Y, Lewenthal, H, Lusler, V (1982): Outcome of pregnancy in 31 triplet gestations. Obstet Gynecol 59:472–476.Google ScholarPubMed
7.Itzkowic, D (1979): A survey of 59 triplet pregnancies. Br J Obstet Gynaecol 86:23–28.CrossRefGoogle ScholarPubMed
8.Kanppila, A, Jouppila, P, Koivito, Met al (1975): Twin pregnancy: A clinical study of 335 cases. Acta Obstet Gynecol Scand 44:5–20.Google Scholar
9.Koivisto, M, Jouppila, P, Kanppila, Aet al (1975): Twin pregnancy: Neonatal morbidity and mortality. Acta Obstet Gynecol. Scand 44:21–30.Google Scholar
10.Loucopoulos, A, Jewelewicz, R (1982): Management of multifetal pregnancies: Sixteen years experience at the Sloane Hospital for Women. Am J Obstet Gynecol 143:902–905.CrossRefGoogle Scholar
11.Lunenfeld, B, Isler, V (1978): Diagnosis and Treatment of Functional Infertility. Berlin: Grosse, 78–83.Google Scholar
12.McFee, JG, Lord, EL, Jeffrey, RL, et al (1974): Multiple gestations of higher fetal number. Obstet Gynecol 44:99.Google Scholar
13.Michlewitz, H, Kennedy, J, Kawada, C, Kennison, R (1981): Triplet pregnancies. J Reprod Med 26: 243–246.Google ScholarPubMed
14.Shenker, JG, Simha, A (1975): Quintuplet pregnancy. Obstet Gynecol 45:590–594.Google Scholar