Mazhar Syeda Batool, Rahim Fariha, Furukh Tehmina
Department of Gynaecology and Obstetrics, Unit II, Mother and Child Health Centre, Islamabad.
J Coll Physicians Surg Pak. 2008 Apr;18(4):217-21.
To determine maternal outcome as antenatal and postnatal complications and neonatal outcome as birth weight, morbidity and mortality in triplet gestation.
Observational study.
Mother and Child Health (MCH) Centre, Pakistan Institute of Medical Sciences, Islamabad from May 2000 to April 2006.
All the patients with triplet pregnancy beyond 28 weeks gestation, who delivered at the study place during above period were included in the study. The primary outcome measures were frequency of maternal complications and neonatal birth, weight and morbidity. Secondary outcome measures included the frequency of assisted conception in the studied cohort.
Eighteen women had triplet pregnancy beyond 28 weeks. Nine were booked, 6 non-booked and 3 of them were referred. Mean duration of gestation was 237.8 days (33.8 weeks). The antenatal complications were preterm delivery in 50%, hypertension in 50%, anemia in 44.4% and obstetric cholestasis in 5.6%. Eight patients (44.4%) suffered postpartum hemorrhage. One patient had peripartum hysterectomy and later expired in intensive care unit after three weeks. Maternal mortality ratio was 5.6%. Fifty five percent women had induction of ovulation with Clomiphene, while none had In Vitro Fertilization (IVF) or Intracytoplasmic Insemination (ICSI) or received gonadotrophins. Fifteen sets of triplets were delivered abdominally. Mean birth weights of 1st, 2nd and 3rd triplet were 1651, 1640 and 1443 grams respectively. Five sets of triplets (27.8%) had more than 25% discordance for birth weight. The mean Apgar scores of the babies at 1 and 10 minutes after birth were 6.0 and 8.0, 5.6 and 7.5; and 5.2 and 7.0 respectively. Of the 54 infants, 18 required Neonatal Intensive Care Unit (NICU) admission and 14 were admitted in nursery. Two died shortly after birth. Total perinatal mortalities were 13 including 4 cases of intra-uterine demise. Three babies suffered from jaundice, 7 had sepsis and 8 had respiratory distress syndrome.
Triplet gestation had a high rate of fetomaternal complications. Majority had history of assisted conception.
确定三胎妊娠的孕产妇结局（如产前和产后并发症）以及新生儿结局（如出生体重、发病率和死亡率）。
观察性研究。
2000年5月至2006年4月，位于伊斯兰堡的巴基斯坦医学科学研究所母婴健康中心。
纳入所有妊娠28周以上的三胎妊娠患者，这些患者在上述期间于研究地点分娩。主要结局指标为孕产妇并发症的发生率以及新生儿出生情况、体重和发病率。次要结局指标包括研究队列中辅助受孕的发生率。
18名妇女妊娠28周以上为三胎妊娠。9名已登记建档，6名未登记建档，其中3名是转诊而来。平均妊娠时长为237.8天（33.8周）。产前并发症包括50%的早产、50%的高血压、44.4%的贫血和5.6%的产科胆汁淤积症。8名患者（44.4%）发生产后出血。1名患者进行了围产期子宫切除术，三周后在重症监护病房死亡。孕产妇死亡率为5.6%。55%的妇女使用克罗米芬诱导排卵，无人接受体外受精（IVF）或卵胞浆内单精子注射（ICSI）或使用促性腺激素。15组三胞胎经剖宫产分娩。第一、第二和第三个三胞胎的平均出生体重分别为1651克、1640克和1443克。5组三胞胎（27.8%）出生体重差异超过25%。婴儿出生后1分钟和10分钟的平均阿氏评分分别为6.0和8.0、5.6和7.5、5.2和7.0。54名婴儿中，18名需要入住新生儿重症监护病房（NICU），14名入住婴儿室。2名婴儿出生后不久死亡。围产期总死亡人数为13人，其中包括4例宫内死亡。3名婴儿患黄疸，7名患败血症，8名患呼吸窘迫综合征。
三胎妊娠母婴并发症发生率高。大多数有辅助受孕史。
