A prospective comparison of the outcome of triplet pregnancies managed expectantly or by multifetal reduction to twins

Shlomo Lipitz, Brian Reichman, Jefet Uval, Josef Shalev, Reuven Achiron, Gad Barkai, Ayala Lusky, Shlomo Mashiach

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: Our aim was to compare the outcome of triplet pregnancies managed expectantly or by multifetal reduction to twins. STUDY DESIGN: From January 1984 through January 1992, 140 triplet gestations were diagnosed before the ninth gestational week. Multifetal pregnancy reduction was performed at the patient's request in 34 women. The remaining 106 triplet pregnancies were managed expectantly. All patients were prospectively followed up and delivered in a single perinatal department. RESULTS: Loss of the entire pregnancy before 25 gestational weeks occurred in 20.7% of the triplet pregnancies managed expectantly as compared with 8.7% in the group with reduction to twins. A successful pregnancy as defined by the discharge home of at least one infant occurred in 88.2% of the group with reduction to twins and 74.5% of the triplets managed expectantly. Fetal reduction to twins was associated with a significantly lower incidence of the following: prematurity (p < 0.001), low-birth-weight infants (p < 0.001), and very-low-birth-weight infants (p < 0.001). Pregnancy complications and neonatal morbidity and mortality were less in the group with reduction to twins. CONCLUSIONS: Multifetal pregnancy reduction of triplet pregnancies to twins resulted in improved pregnancy outcome without an excess loss of the entire pregnancy as compared with the outcome of triplet gestations managed expectantly. (AM J OBSTET GYNECOL 1994;170:874-9.)

Original languageEnglish
Pages (from-to)874-879
Number of pages6
JournalAmerican Journal of Obstetrics and Gynecology
Volume170
Issue number3
DOIs
StatePublished - 1994

Keywords

  • Triplet gestation
  • multifetal pregnancy reduction
  • pregnancy outcome

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