Downing Maureen, Sulo Suela, Parilla Barbara V
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Advocate Lutheran General Hospital, Park Ridge, Illinois.
The James R. and Helen D. Russell Institute for Research & Innovation, Advocate Lutheran General Hospital, Park Ridge, Illinois.
AJP Rep. 2017 Jan;7(1):e59-e63. doi: 10.1055/s-0037-1599124.
To compare perinatal and neonatal outcomes of dichorionic (DC) and monochorionic (MC) with trichorionic (TC) triplet gestations. A retrospective cohort study of DC + MC versus TC triplet gestations delivered at a tertiary care hospital from 2009 to 2015. The results include 42 sets of triplets (TC, = 26; DC + MC, = 16). Maternal demographics and pregnancy data were compared. Neonatal outcomes were assessed using composite morbidity and mortality. Maternal baseline characteristics including age, mode of conception, race, parity, body mass index, and previous preterm delivery were statistically comparable. Comparison of prenatal management and complications yielded no significant differences in terms of presence of shortened cervix, cerclage placement, use of tocolytics, intrauterine growth restriction, premature rupture of membranes, pregnancy-induced hypertension, or gestational diabetes. However, evaluation of composite morbidity and mortality (RDS, IVH, NEC, IUGR, and death) illustrated that all infants born from DC + MC triplet gestations suffered some morbidity or mortality compared with TC pregnancies ( < 0.01). DC + MC triplet gestations are at an increased risk of neonatal morbidity and mortality compared with TC triplet gestations.
比较双绒毛膜（DC）和单绒毛膜（MC）三胎妊娠与三绒毛膜（TC）三胎妊娠的围产期和新生儿结局。 对2009年至2015年在一家三级护理医院分娩的DC+MC与TC三胎妊娠进行回顾性队列研究。结果包括42组三胞胎（TC，=26；DC+MC，=16）。比较了产妇人口统计学和妊娠数据。使用综合发病率和死亡率评估新生儿结局。 产妇基线特征，包括年龄、受孕方式、种族、产次、体重指数和既往早产情况，在统计学上具有可比性。产前管理和并发症的比较在宫颈缩短、宫颈环扎术、宫缩抑制剂的使用、胎儿生长受限、胎膜早破、妊娠高血压或妊娠期糖尿病的存在方面没有显著差异。然而，综合发病率和死亡率（呼吸窘迫综合征、脑室内出血、坏死性小肠结肠炎、胎儿生长受限和死亡）的评估表明，与TC妊娠相比，所有DC+MC三胎妊娠出生的婴儿都有一定的发病率或死亡率（<0.01）。 DC+MC三胎妊娠与TC三胎妊娠相比，新生儿发病率和死亡率风险增加。
