Department of Obstetrics and Gynecology, Faculty of Medicine, Kuwait University, Safat, P.O. Box 24923, Kuwait, 13110, Kuwait,
Arch Gynecol Obstet. 2013 Oct;288(4):759-67. doi: 10.1007/s00404-013-2796-x. Epub 2013 Mar 30.
To review the maternal and fetal outcome of triplet, quadruplet and quintuplet gestations following ART, which were managed at a hospital over 11 years.
Retrospective chart review of 150 triplet, 27 quadruplet, and 6 quintuplet pregnancies between January 2001 and December 2011. 25 women aged 50-56 years with triplet pregnancies, were excluded due to lack of data. No prophylactic interventions were used.
300 triplets, 108 quadruplets, and 30 quintuplets were born. The mean maternal age was 30.2 years (SD 4.2 years). Mean gestational age delivery was 32.2 weeks (SD 4.2 weeks). Maternal complications included preterm labor 114 (86 %), prematurity 115 (87 %), anemia 44 (33 %) gestational diabetes 35 (27 %), preeclampsia 33 (25 %), post partum hemorrhage 13 (10 %). Preterm labor was diagnosed in 84 (84 %) triplets, 32 (97 %) of quadru- and quintuplet pregnancies (P > 0.05). Prematurity and preterm labor were major determinants. Of the 438 fetuses born there were 57 (13 %) still births, 77 (18 %) neonatal deaths. 32 (7 %) were early neonatal deaths, 45 (10 %) late neonatal deaths. The majority died due to extreme low birth weight. 75 (17 %) neonates had low apgar score of <7 at 5 min. 22 (5 %) infants had congenital anomalies. Severe respiratory distress syndrome, perinatal asphyxia, very early preterm delivery and perinatal mortality were higher in quadru- and quintuplets (P < 0.05).
Preterm labor and preterm prematurity were the commonest complications. Neonatal mortality and morbidity was significantly increased in quadru- and quintuplets. Prophylactic interventions were not used in an attempt to prevent preterm labor.
回顾 11 年间在一家医院接受辅助生殖技术（ART）治疗的三胞胎、四胞胎和五胞胎的母婴结局。
对 2001 年 1 月至 2011 年 12 月期间的 150 例三胞胎、27 例四胞胎和 6 例五胞胎妊娠进行回顾性图表分析。25 名年龄在 50-56 岁的三胞胎孕妇因数据缺失而被排除在外。未使用预防性干预措施。
共分娩了 300 例三胞胎、108 例四胞胎和 30 例五胞胎。产妇平均年龄为 30.2 岁（标准差为 4.2 岁）。平均分娩孕周为 32.2 周（标准差为 4.2 周）。母体并发症包括早产 114 例（86%）、早产 115 例（87%）、贫血 44 例（33%）、妊娠期糖尿病 35 例（27%）、子痫前期 33 例（25%）、产后出血 13 例（10%）。84 例（84%）三胞胎、32 例（97%）四胞胎和五胞胎患者诊断为早产（P>0.05）。早产和早产是主要决定因素。在 438 例出生的胎儿中，有 57 例（13%）死胎，77 例（18%）新生儿死亡。32 例（7%）为早期新生儿死亡，45 例（10%）为晚期新生儿死亡。大多数死亡是由于极低出生体重。75 例（17%）新生儿出生时 5 分钟内 Apgar 评分为<7。22 例（5%）婴儿有先天性异常。严重呼吸窘迫综合征、围产期窒息、极早产和围产儿死亡率在四胞胎和五胞胎中更高（P<0.05）。
早产和早产是最常见的并发症。四胞胎和五胞胎的新生儿死亡率和发病率显著增加。为了预防早产，没有使用预防性干预措施。
