RSS-Feed abonnieren
DOI: 10.1055/s-0029-1220776
Perinatal and Neonatal Outcomes of Triplet Gestations Based on Placental Chorionicity
Publikationsverlauf
Publikationsdatum:
15. April 2009 (online)
![](https://www.thieme-connect.de/media/ajp/200908/lookinside/thumbnails/10.1055-s-0029-1220776-1.jpg)
ABSTRACT
The purpose of our study was to evaluate perinatal and neonatal outcomes in triplet gestations in relation to placental chorionicity. We hypothesized that triplets containing a monochorionic pair (dichorionic triamniotic) would have increased morbidity compared with triplets without a monochorionic pair (trichorionic triamniotic). We retrospectively analyzed all triplet sets ≥20 weeks delivering at our institutions from January 1995 through April 2007. Data were collected via perinatal and neonatal databases, chart review, and placental pathology. Individuals in dichorionic triamniotic triplet sets (n = 75), when compared with trichorionic triamniotic triplets (n = 309), were more likely to have a lower mean birth weight (p < 0.001) and lower gestational age at delivery (p < 0.001), spend more days in the neonatal intensive care unit (p = 0.045), have culture-proven sepsis (p = 0.02), and require intubation (p = 0.05). Multivariate analysis demonstrated that dichorionicity is not an independent cause of morbidity, but results in earlier delivery and lower birth weight. Dichorionic triamniotic triplets are at increased risk for earlier deliveries and lower birth weight at delivery compared with trichorionic triamniotic triplets.
KEYWORDS
Triplets - chorionicity - outcomes
REFERENCES
- 1 Bajoria R, Kingdom J. The case for routine determination of chorionicity and zygosity in multiple pregnancy. Prenat Diagn. 1997; 17 1203-1225
- 2 Adegbite A L, Ward S B, Bajoria R. Perinatal outcome of spontaneously conceived triplet pregnancies in relation to chorionicity. Am J Obstet Gynecol. 2005; 193 1463-1471
- 3 Bajoria R, Ward S, Adegbite A. Comparative study of perinatal outcome of dichorionic and trichorionic iatrogenic triplets. Am J Obstet Gynecol. 2006; 194 415-424
- 4 Chasen S T, Al-Kouatly H B, Ballabh P, Skupski D W, Chervenak F A. Outcomes of dichorionic triplet pregnancies. Am J Obstet Gynecol. 2002; 186 765-767
- 5 Sebire N J, Snijders R JM, Hughes K, Sepulveda W, Nicolaides K H. The hidden mortality of monochorionic twin pregnancies. Br J Obstet Gynaecol. 1997; 104 1203-1207
- 6 Glinianaia S V, Skjaerven R, Magnus P. Birthweight percentiles by gestational age in multiple births. Acta Obstet Gynecol Scand. 2000; 79 450-458
- 7 Stenhouse E, Hardwick C, Maharaj S, Webb J, Kelly T, Mackenzie F M. Chorionicity determination in twin pregnancies: how accurate are we?. Ultrasound Obstet Gynecol. 2002; 19 350-352
- 8 Zuppa A A, Scorrano A, Cota F, D'Andrea V, Fracchiolla A, Romagnoli C. Neonatal outcomes in triplet pregnancies: assisted reproduction versus spontaneous conception. J Perinat Med. 2007; 35 339-343
- 9 Devine P C, Malone F D, Athanassiou A, Harvey-Wilkes K, D'Alton M E. Maternal and neonatal outcome of 100 consecutive triplet pregnancies. Am J Perinatol. 2001; 18 225-235
Jeffrey V SpencerM.D.
Anne Arundel Medical Center, Center for Maternal and Fetal Medicine
820 Bestgate Rd, Suite 26, Annapolis, MD 21401
eMail: vahan1000@yahoo.com