Journal de biologie néonatale

Abstrait

Study of a Population of Triplet Pregnancies: Maternal and Neonatal Outcomes

Donatella Caserta, Giulia Bordi, Michele Stegagno, Francesca Filippini, Maria Podagrosi, Domenico Roselli and Massimo Moscarini

Objective: To describe maternal complications, perinatal mortality and neonatal morbidity in triplet pregnancies. Methods: Retrospective analysis of maternal and neonatal records of 21 triplet pregnancies delivered from January 2008 to June 2011 at San Pietro FBF Hospital of Rome, a tertiary medical center.

Results: The incidence of triplet pregnancies was one in 690 births. Among the 21 triplet pregnancies, only one was conceived spontaneously and 20 were the result of assisted reproductive techniques. Mean maternal age was 34.4 ± 5 years. There was one case of a selective foeticide of a foetus with an encephalocele. Preterm delivery occurred in all the remaining 20 pregnancies. Other frequent complications were premature rupture of membranes (40%) and cervical incompetence (35%). There was no maternal mortality in any of the studied pregnancies. The mean length of maternal hospitalization was 15 ± 5.9 days. The mean gestational age was 31.8 weeks, with a mean birth weight of 1590 ± 590 grams. The neonatal mortality was 5%. The incidence of congenital anomalies was 16.7%. Respiratory distress syndrome occurred in 53% of cases and 75.6% of newborns required intensive care. Other common neonatal complications were jaundice (66.7%), anaemia (28.9%), patent ductus arteriosus (24.4%), apnea of prematurity (17.8%), sepsis (13.3%), neurological complications (11.1%) and bronchopulmonary dysplasia (11.1%). The mean length of newborns hospitalization was 33.6 ± 23.3 days. There was no significant difference in neonatal mortality and morbidity based on birth order.

Conclusions: This series of triplet pregnancies demonstrated an excellent survival rate and a relatively low major morbidity, despite the 100% incidence of prematurity. Although perinatal outcomes in triplet gestations have improved in recent years, higher-order multiple pregnancies continued to be associated with great medical problems for both mothers and infants. All methods of assisted reproduction should aim for the prevention of multifetal pregnancies