Skip to main content
Top
Published in: Archives of Gynecology and Obstetrics 4/2009

01-04-2009 | Original Article

Twenty-six triplet pregnancies: a retrospective analysis

Authors: Bernhard Kraemer, Sven Becker, Karl Oliver Kagan, Markus Hahn, Taufiek K. Rajab, Diethelm Wallwiener, Elizabeth Kraemer, Harald Abele

Published in: Archives of Gynecology and Obstetrics | Issue 4/2009

Login to get access

Abstract

Methods

Twenty-six triplet pregnancies were delivered over 6 years.

Results

Over 80% of pregnancies resulted after infertility treatment (21/26). Mean maternal age was 32. On average, the infants were delivered after 32 + 0 weeks; in 4 cases delivery was at <28 weeks. In 1 case, the leading triplet was delivered spontaneously, the remaining babies by Caesarean. Main indications for Caesarean were: premature membrane rupture, premature contractions, maternal hospitalisation for foetal lung maturation/tocolysis/antibiotics. Mean birth weights were (triplet I–III): 1,730, 1,630 and 1,550 g. Hydrops fetalis and renal agenesis resulted in IUFD of the leading triplet in two cases. All newborns were cared for by neonatology.

Conclusions

Triplet pregnancies are challenging for all specialities involved. They should be managed from an early stage in cooperation with an experienced centre, allowing outpatient care for as long as possible if there are no complications. This also has a cost-reducing impact.
Literature
1.
go back to reference Martin JA, Park MM (1999) Trends in twin and triplet births, 1980–1997. National Vital Statistics Reports, vol 47, No. 24, DHHS Publication no. (PHS) 99–1120, Department of Health and human Services, National Center for health Statistics, Hyattsville, MD Martin JA, Park MM (1999) Trends in twin and triplet births, 1980–1997. National Vital Statistics Reports, vol 47, No. 24, DHHS Publication no. (PHS) 99–1120, Department of Health and human Services, National Center for health Statistics, Hyattsville, MD
2.
go back to reference DIR Jahrbuch (2000) DIR Bundesgeschäftsstelle bei der Ärztekammer Schleswig Holstein, Bad Segeberg DIR Jahrbuch (2000) DIR Bundesgeschäftsstelle bei der Ärztekammer Schleswig Holstein, Bad Segeberg
3.
go back to reference Kaufman GE, Malone FD, Harvey-Wilkes KB, Chelmow D, Penzias AS, D’Alton ME (1998) Neonatal morbidity and mortality associated with triplet gestation. Obstet Gynecol 91(3):342–348PubMedCrossRef Kaufman GE, Malone FD, Harvey-Wilkes KB, Chelmow D, Penzias AS, D’Alton ME (1998) Neonatal morbidity and mortality associated with triplet gestation. Obstet Gynecol 91(3):342–348PubMedCrossRef
4.
go back to reference Wen SW, Demissie K, Yang Q, Walker MC (2004) Maternal morbidity and obstetric complications in triplet pregnancies and quadruplet and higher-order multiple pregnancies. Am J Obstet Gynecol 191:254–258PubMedCrossRef Wen SW, Demissie K, Yang Q, Walker MC (2004) Maternal morbidity and obstetric complications in triplet pregnancies and quadruplet and higher-order multiple pregnancies. Am J Obstet Gynecol 191:254–258PubMedCrossRef
5.
go back to reference Daw E (1978) Triplet pregnancy. Br J Obstet Gynecol 85:505–509 Daw E (1978) Triplet pregnancy. Br J Obstet Gynecol 85:505–509
6.
go back to reference Itzkowic D (1979) Survey of 59 triplet pregnancies. Br J Obstet Gynecol 86:23–28 Itzkowic D (1979) Survey of 59 triplet pregnancies. Br J Obstet Gynecol 86:23–28
7.
go back to reference Blondel B, Kaminski M (2002) Trends in the occurrence, determinants, and consequences of multiple births. Semin Perinatol 26:239–249PubMedCrossRef Blondel B, Kaminski M (2002) Trends in the occurrence, determinants, and consequences of multiple births. Semin Perinatol 26:239–249PubMedCrossRef
8.
go back to reference Imaizumi Y (1998) A comparative study of twinning and triplet rates in 17 countries, 1972–1996. Acta Genet Med Gemellol 47(2):101–114PubMed Imaizumi Y (1998) A comparative study of twinning and triplet rates in 17 countries, 1972–1996. Acta Genet Med Gemellol 47(2):101–114PubMed
9.
go back to reference Albrecht JL, Tomich PG (1996) The maternal and neonatal outcome of triplet gestations. Am J Obstet Gynecol 174(5):1551–1556PubMedCrossRef Albrecht JL, Tomich PG (1996) The maternal and neonatal outcome of triplet gestations. Am J Obstet Gynecol 174(5):1551–1556PubMedCrossRef
10.
go back to reference Daw E (1978) Triplet pregnancy. Br J Obstet Gynaecol 85(7):505–509PubMed Daw E (1978) Triplet pregnancy. Br J Obstet Gynaecol 85(7):505–509PubMed
11.
go back to reference Doyle P (1996) The outcome of multiple pregnancy. Hum Reprod 11(Suppl 4):110–117 Discussion 118–120 (Review)PubMed Doyle P (1996) The outcome of multiple pregnancy. Hum Reprod 11(Suppl 4):110–117 Discussion 118–120 (Review)PubMed
12.
go back to reference Keith LG, Oleszczuk JJ, Keith DM (2000) Multiple gestation: reflections on epidemiology, causes, and consequences. Int J Fertil Womens Med 45(3):206–214PubMed Keith LG, Oleszczuk JJ, Keith DM (2000) Multiple gestation: reflections on epidemiology, causes, and consequences. Int J Fertil Womens Med 45(3):206–214PubMed
13.
go back to reference Skrablin S, Kuvacic I, Jukic P, Kalafatic D, Peter B (2002) Hospitalization versus outpatient care in the management of triplet gestations. Int J Obstet Gynecol 77:223–229CrossRef Skrablin S, Kuvacic I, Jukic P, Kalafatic D, Peter B (2002) Hospitalization versus outpatient care in the management of triplet gestations. Int J Obstet Gynecol 77:223–229CrossRef
14.
go back to reference Adams DM, Sholl JS, Haney EI, Russel TL, Silver RK (1998) Perinatal outcome associated with outpatient management of triplet pregnancy. Am J Obstet Gynecol 178(4):843–847PubMed Adams DM, Sholl JS, Haney EI, Russel TL, Silver RK (1998) Perinatal outcome associated with outpatient management of triplet pregnancy. Am J Obstet Gynecol 178(4):843–847PubMed
15.
go back to reference McFee JG, Lord EL, Jeffrey RL, O’Meara OP, Josepher HJ, Butterfield LJ, Thompson HE (1974) Multiple gestations of high fetal number. Obstet Gynecol 44(1):99–106PubMed McFee JG, Lord EL, Jeffrey RL, O’Meara OP, Josepher HJ, Butterfield LJ, Thompson HE (1974) Multiple gestations of high fetal number. Obstet Gynecol 44(1):99–106PubMed
16.
go back to reference Lazar P, Gueguen S, Dreyfus J, Renaud R, Pontonnier G, Papiernik E (1984) Multicentred controlled trial of cervical cerclage in women at moderate risk of preterm delivery. Br J Obstet Gynaecol 91(8):731–735PubMed Lazar P, Gueguen S, Dreyfus J, Renaud R, Pontonnier G, Papiernik E (1984) Multicentred controlled trial of cervical cerclage in women at moderate risk of preterm delivery. Br J Obstet Gynaecol 91(8):731–735PubMed
17.
go back to reference Loucopoulos A, Jewelewicz R (1982) Management of multifetal pregnancies: sixteen years’ experience at the Sloan Hospital for Women. Am J Obstet Gynecol 143(8):902–905PubMed Loucopoulos A, Jewelewicz R (1982) Management of multifetal pregnancies: sixteen years’ experience at the Sloan Hospital for Women. Am J Obstet Gynecol 143(8):902–905PubMed
18.
go back to reference Missfelder-Lobos H, Viehweg B, Vogtmann Ch, Faber R (2003) Perinatales Management und Ausgang von Drillingsschwangerschaften zwischen 1997 und 2001. Z Geburtsh Neonatol 207:179–185 Missfelder-Lobos H, Viehweg B, Vogtmann Ch, Faber R (2003) Perinatales Management und Ausgang von Drillingsschwangerschaften zwischen 1997 und 2001. Z Geburtsh Neonatol 207:179–185
19.
go back to reference Weissman A, Yoffe N, Jakobi P, Brandes JM, Paldi E, Blazer S (1991) Management of triplet pregnancies in the 1980s—are we doing better? Am J Perinatol 8(5):333–337PubMedCrossRef Weissman A, Yoffe N, Jakobi P, Brandes JM, Paldi E, Blazer S (1991) Management of triplet pregnancies in the 1980s—are we doing better? Am J Perinatol 8(5):333–337PubMedCrossRef
20.
go back to reference Peaceman AM, Dooley SL, Tamura RK, Socol ML (1992) Antepartum management of triplet gestations. Am J Obstet Gynecol 167(4Pt1):1117–1120PubMed Peaceman AM, Dooley SL, Tamura RK, Socol ML (1992) Antepartum management of triplet gestations. Am J Obstet Gynecol 167(4Pt1):1117–1120PubMed
21.
go back to reference To MS, Skentou C, Cicero S, Liao AW, Nicolaides KH (2000) Cervical length at 23 weeks in triplets: prediction of spontaneous preterm delivery. Ultrasound Obstet Gynecol 16(6):515–518PubMedCrossRef To MS, Skentou C, Cicero S, Liao AW, Nicolaides KH (2000) Cervical length at 23 weeks in triplets: prediction of spontaneous preterm delivery. Ultrasound Obstet Gynecol 16(6):515–518PubMedCrossRef
22.
go back to reference Welsh A, Nicolaides K (2002) Cervical screening for preterm delivery. Curr Opin Obstet Gynecol 14(2):195–202PubMedCrossRef Welsh A, Nicolaides K (2002) Cervical screening for preterm delivery. Curr Opin Obstet Gynecol 14(2):195–202PubMedCrossRef
23.
go back to reference Strauss A, Heer IM, Janssen U, Dannecker Ch, Hillemanns P, Müller-Egloff S (2002) Routine cervical cerclage in higher order multiple gestation—does it prolong the pregnancy? Twin Res 5(2):67–70PubMedCrossRef Strauss A, Heer IM, Janssen U, Dannecker Ch, Hillemanns P, Müller-Egloff S (2002) Routine cervical cerclage in higher order multiple gestation—does it prolong the pregnancy? Twin Res 5(2):67–70PubMedCrossRef
24.
go back to reference Bernasko J, Lee R, Pagano M, Kohn N (2006) Is routine prophylactic cervical cerclage associated with significant prolongation of triplet gestation? J Matern Fetal Neonatal Med 19(9):575–578PubMedCrossRef Bernasko J, Lee R, Pagano M, Kohn N (2006) Is routine prophylactic cervical cerclage associated with significant prolongation of triplet gestation? J Matern Fetal Neonatal Med 19(9):575–578PubMedCrossRef
25.
go back to reference Rebarber A, Roman AS, Istwan N, Rhea D, Stanziano G (2005) Prophylactic cerclage in the management of triplet pregnancies. Am J Obstet Gynecol 193(3 Pt 2):1193–1196PubMedCrossRef Rebarber A, Roman AS, Istwan N, Rhea D, Stanziano G (2005) Prophylactic cerclage in the management of triplet pregnancies. Am J Obstet Gynecol 193(3 Pt 2):1193–1196PubMedCrossRef
26.
go back to reference Boulot P, Hedon B, Pelliccia G, Sarda P, Montoya F, Mares P, Humeau C, Arnal F, Laffargue F, Viala JL (1992) Favourable outcome in 33 triplet pregnancies managed between 1985–1990. Eur J Obstet Gynecol Reprod Biol 43(2):123–129PubMedCrossRef Boulot P, Hedon B, Pelliccia G, Sarda P, Montoya F, Mares P, Humeau C, Arnal F, Laffargue F, Viala JL (1992) Favourable outcome in 33 triplet pregnancies managed between 1985–1990. Eur J Obstet Gynecol Reprod Biol 43(2):123–129PubMedCrossRef
27.
go back to reference Dommergues M, Mahieu-Caputo D, Mandelbrot L, Huon C, Moriette G, Dumez Y (1995) Delivery of uncomplicated triplet pregnancies: is the vaginal route safer? A case-control study. Am J Obstet Gynecol 172(2 Pt 1):513–517PubMedCrossRef Dommergues M, Mahieu-Caputo D, Mandelbrot L, Huon C, Moriette G, Dumez Y (1995) Delivery of uncomplicated triplet pregnancies: is the vaginal route safer? A case-control study. Am J Obstet Gynecol 172(2 Pt 1):513–517PubMedCrossRef
Metadata
Title
Twenty-six triplet pregnancies: a retrospective analysis
Authors
Bernhard Kraemer
Sven Becker
Karl Oliver Kagan
Markus Hahn
Taufiek K. Rajab
Diethelm Wallwiener
Elizabeth Kraemer
Harald Abele
Publication date
01-04-2009
Publisher
Springer-Verlag
Published in
Archives of Gynecology and Obstetrics / Issue 4/2009
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-009-0929-z

Other articles of this Issue 4/2009

Archives of Gynecology and Obstetrics 4/2009 Go to the issue