Weissman A, Yoffe N, Jakobi P, Brandes J M, Paldi E, Blazer S
Department of Obstetrics & Gynecology, Rambam Medical Center, Technion-Faculty of Medicine, Haifa, Israel.
Am J Perinatol. 1991 Sep;8(5):333-7. doi: 10.1055/s-2007-999408.
The incidence of triplet pregnancies has increased with the introduction of ovulation induction agents and is expected to further increase with the implementation of multiple embryo transfer in the in vitro fertilization programs. We review our experience with 29 triplet pregnancies in the last 10 years. Despite early sonographic diagnosis, close follow-up, increased use of tocolytics, and prophylactic cervical suture, we could not document prolongation of pregnancy, increased infants' weight, or a significantly decreased perinatal mortality, which still remains about 14%. Furthermore, the use of cesarean section as the delivery method of choice did not change the well-documented unfavorable relationship between birth order and fetal outcome. There is an urgent need for prospective assessment of the value of different treatment modalities, which nowadays becomes possible with the increasing incidence of triplet pregnancies. The prevention of triplet pregnancies or treatment by selective fetal reduction deserves a second thought.
随着排卵诱导剂的应用，三胎妊娠的发生率有所增加，并且随着体外受精项目中多胚胎移植的实施，预计其发生率还会进一步上升。我们回顾了过去10年中29例三胎妊娠的经验。尽管进行了早期超声诊断、密切随访、增加了宫缩抑制剂的使用以及预防性宫颈缝合，但我们未能证实妊娠得以延长、婴儿体重增加或围产期死亡率显著降低，围产期死亡率仍约为14%。此外，选择剖宫产作为分娩方式并未改变已被充分证明的出生顺序与胎儿结局之间的不利关系。迫切需要对不同治疗方式的价值进行前瞻性评估，而如今随着三胎妊娠发生率的增加，这已成为可能。对于三胎妊娠的预防或通过选择性减胎术进行治疗值得重新考虑。
