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The Northwestern University Triplet Study. III: Neonatal Outcome

Published online by Cambridge University Press:  01 August 2014

J.W. Collins Jr.
Affiliation:
Departments of Pediatrics and of Obstetrics and Gynecology, Northwestern University Medical School, Chicago, Illinois, USA Prentice Women's Hospital and Maternity Center, and Evanston Hospital, Chicago, Illinois, USA
D. Merrick
Affiliation:
Departments of Pediatrics and of Obstetrics and Gynecology, Northwestern University Medical School, Chicago, Illinois, USA Prentice Women's Hospital and Maternity Center, and Evanston Hospital, Chicago, Illinois, USA
R.J. David
Affiliation:
Departments of Pediatrics and of Obstetrics and Gynecology, Northwestern University Medical School, Chicago, Illinois, USA Prentice Women's Hospital and Maternity Center, and Evanston Hospital, Chicago, Illinois, USA
S. Ameli
Affiliation:
Departments of Pediatrics and of Obstetrics and Gynecology, Northwestern University Medical School, Chicago, Illinois, USA Prentice Women's Hospital and Maternity Center, and Evanston Hospital, Chicago, Illinois, USA
E.S. Ogata*
Affiliation:
Departments of Pediatrics and of Obstetrics and Gynecology, Northwestern University Medical School, Chicago, Illinois, USA Prentice Women's Hospital and Maternity Center, and Evanston Hospital, Chicago, Illinois, USA
*
333 E. Superior Street, Rm 1106, Chicago, IL 60611, USA

Abstract

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Limited data suggest that cesarean section (CS) may be the preferred method of delivery for triplets. Despite this, it is also felt that the third triplet is at great risk at delivery. We reviewed our experience of 14 triplet pregnancies at Northwestern University between 1981 and 1985. All deliveries were attended by neonatal teams in sufficient number to resuscitate each infant. Of the 14 pregnancies, two ended in previable loss. Thirty-six infants were born from 12 pregnancies of a mean gestational age of 33 weeks (28-38 weeks). The overall survival was 97.3%. Two women delivered vaginally. While the first was successful, the second resulted in vaginal delivery of the first two triplets followed by emergency CS for the third. That infant had a cord blood pH of 6.96(BE-19), was resuscitated and survived. All 10 CS were successful. The mean cord blood gas tensions and pH were normal. In addition, Apgar scores, the requirement for mechanical ventilation or supplemental oxygen, and mortality did not differ between the first and thirdborn triplet. These observations suggest that CS was beneficial. Our very low mortality rate supports the concept that CS delivery and aggressive neonatal resuscitation and therapy greatly enhances survival.

Type
Research Article
Copyright
Copyright © The International Society for Twin Studies 1988

References

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