Perinatal outcome of dichorionic-triamniotic as compared to trichorionic triplets
-
Teresinha Simões
Abstract
Objective:
To evaluate if the perinatal outcomes of dichorionic-triamniotic (DC) triplets are significantly different than that of trichorionic (TC) triplets.
Study design:
Comparison of maternal and neonatal data of 44 DC to 46 TC triplets, using univariate analysis.
Results:
DC triplets were significantly more common after spontaneous conception but all other maternal characteristics as well complications and cesarean section rates were similar. Both groups had similar incidence of birth at <32 and <28 weeks as well as similar incidence of very low and extremely low birth weight. There was similar incidence of neonatal morbidity except for twin-twin transfusion syndrome (13.6%) in the DC group. The stillbirth rate was 45/1000 and 29/1000, the early neonatal mortality rates were 63/1000 and 45/1000, and the perinatal mortality rate was 106/1000 and 72/1000 for DC and TC triplets, respectively (all not significantly different).
Conclusions:
Our data indicate that DC twins are not significantly disadvantaged compared to TC triplets and the similar outcomes might be reassuring for those who consider continuing their DC triplet pregnancy.
References
[1] Blickstein I, Keith LG. The decreased rates of triplet births: temporal trends and biologic speculations. Am J Obstet Gynecol. 2005;193:327–31.10.1016/j.ajog.2005.01.007Suche in Google Scholar PubMed
[2] Derom R, Derom C. Placentation. In: Blickstein I, Keith LG, editors. Multiple pregnancy: epidemiology, gestation, and perinatal outcome. London: Taylor and Francis Group; 2005. p. 157–67.Suche in Google Scholar
[3] Guilherme R, Drunat S, Delezoide AL, Oury JF, Luton D. Zygosity and chorionicity in triplet pregnancies: new data. Hum Reprod. 2009;24:100–5.10.1093/humrep/den364Suche in Google Scholar PubMed
[4] De Catte L, Camus M, Foulon W. Monochorionic high-order multiple pregnancies and multifetal pregnancy reduction. Obstet Gynecol. 2002;100:561–6.10.1097/00006250-200209000-00026Suche in Google Scholar
[5] Skiadas CC, Missmer SA, Benson CB, Acker D, Racowsky C. Impact of selective reduction of the monochorionic pair in in vitro fertilization triplet pregnancies on gestational length. Fertil Steril. 2010;94:2930–1.10.1016/j.fertnstert.2010.05.032Suche in Google Scholar PubMed
[6] Chaveeva P, Kosinski P, Puglia D, Poon LC, Nicolaides KH. Trichorionic and dichorionic triplet pregnancies at 10-14 weeks: outcome after embryo reduction compared to expectant management. Fetal Diagn Ther. 2013;34:199–205.10.1159/000356170Suche in Google Scholar PubMed
[7] Sepulveda W, Surerus E, Vandecruys H, Nicolaides KH. Fetofetal transfusion syndrome in triplet pregnancies: outcome after endoscopic laser surgery. Am J Obstet Gynecol. 2005;192:161–4.10.1016/j.ajog.2004.05.083Suche in Google Scholar PubMed
[8] Chasen ST, Al-Kouatly HB, Ballabh P, Skupski DW, Chervenak FA. Outcomes of dichorionic triplet pregnancies. Am J Obstet Gynecol. 2002;186:765–7.10.1067/mob.2002.122097Suche in Google Scholar PubMed
[9] Geipel A, Berg C, Katalinic A, Plath H, Hansmann M, Germer U, et al. Prenatal diagnosis and obstetric outcomes in triplet pregnancies in relation to chorionicity. Br J Obstet Gynaeol. 2005;112:554–558.10.1111/j.1471-0528.2005.00627.xSuche in Google Scholar PubMed
[10] Bajoria R, Ward SB, Adegbite AL. Comparative study of perinatal outcome of dichorionic and trichorionic iatrogenic triplets. Am J Obstet Gynecol. 2006;194:415–24.10.1016/j.ajog.2005.08.009Suche in Google Scholar PubMed
[11] Kawaguchi H, Ishii K, Yamamoto R, Hayashi S, Mitsuda N; Perinatal Research Network Group in Japan. Perinatal death of triplet pregnancies by chorionicity. Am J Obstet Gynecol. 2013;209:36.e1–7.10.1016/j.ajog.2013.03.003Suche in Google Scholar PubMed
[12] Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008;36:309–32.10.1016/j.ajic.2008.03.002Suche in Google Scholar PubMed
[13] Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birthweights less than 1500 g. J Pediatr. 1978;92:529–34.10.1016/S0022-3476(78)80282-0Suche in Google Scholar
[14] Volpe JJ. Neurology of the newborn. 4th ed. Philadelphia: WB Saunders; 2001. p. 428–93.Suche in Google Scholar
[15] de Vries LS, Eken P, Dubowitz LMS. The spectrum of leukomalacia using cranial ultrasound. Behav Brain Res. 1992;49:1–6.10.1016/S0166-4328(05)80189-5Suche in Google Scholar
[16] Neu J. Necrotizing enterocolitis: the search for a unifying pathogenic theory leading to prevention. Pediatr Clin North Am. 1996;43:409–32.10.1016/S0031-3955(05)70413-2Suche in Google Scholar
[17] Martin JA, Hamilton BE, Ventura SJ, Osterman MJK, Kirmeyer S, Mathews TJ, et al. Birth: final data for 2009. Nat Vital Statistics Rep. 2011;60:1–70Suche in Google Scholar
[18] Argoti PS, Papanna R, Bebbington MW, Kahlek N, Baschat A, Johnson A, et al. Outcome of fetoscopic laser ablation for twin-to-twin transfusion syndrome in dichorionic-triamniotic triplets compared with monochorionic-diamniotic twins. Ultrasound Obstet Gynecol. 2014;44:545–9.10.1002/uog.13369Suche in Google Scholar PubMed
[19] Chmait RH, Kontopoulos E, Bornick PW, Maitino T, Quintero RA. Triplets with feto-fetal transfusion syndrome treated with laser ablation: the USFetus experience. J Matern Fetal Neonatal Med. 2010;23:361–510.3109/14767050903177201Suche in Google Scholar
[20] Ishii K, Nakata M, Wada S, Hayashi S, Murakoshi T, Sago H. Perinatal outcome after laser surgery for triplet gestations with feto-fetal transfusion syndrome. Prenat Diagn. 2014;34:734–8.10.1002/pd.4357Suche in Google Scholar PubMed
[21] Chaveeva P, Kosinski P, Birdir C, Orosz L, Nicolaides KH. Embryo reduction in dichorionic triplets to dichorionic twins by intrafetal laser. Fetal Diagn Ther. 2014;35:83–6.10.1159/000356950Suche in Google Scholar PubMed
[22] Blickstein I, Rhea DJ, Keith LG. The likelihood of adverse outcomes in triplet pregnancies estimated by pregravid maternal characteristics. Fertil Steril. 2004;81:1079–82.10.1016/j.fertnstert.2003.08.046Suche in Google Scholar PubMed
The authors stated that there are no conflicts of interest regarding the publication of this article.
©2016 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Editorial
- Multiple gestation: more research challenges to come
- Highlight articles - Multiples
- Fertility treatment and dichorionic discordant twins – are they related?
- Intertwin estimated fetal weight or crown rump length discordance and adverse perinatal outcome
- Prospective risk of intrauterine death of monochorionic twins: update
- Perinatal outcome of dichorionic-triamniotic as compared to trichorionic triplets
- Outcome of monochorionic-biamniotic twins conceived by assisted reproduction: a population-based study
- Neonatal morbidities and need for intervention in twins and singletons born at 34–35 weeks of gestation
- Glucose tolerance in singleton, twin and triplet pregnancies
- Respiratory morbidity in twins by birth order, gestational age and mode of delivery
- Neonatal outcomes of twin pregnancies delivered at late-preterm versus term gestation based on chorionicity and indication for delivery
- Original papers - Newborn
- Congenital diaphragmatic hernia – a Belgrade single center experience
- Iron homeostasis after blood transfusion in stable preterm infants – an observational study
- Detection and quantification of left-to-right shunting using transpulmonary ultrasound dilution (TPUD): a validation study in neonatal lambs
- Clinical utility of transcutaneous bilirubinometer (TcB) in very low birth weight (VLBW) infants
- Outcome of small for gestational age preterm singletons: a population-based cohort study
- Congress Calendar
- Congress Calendar
Artikel in diesem Heft
- Frontmatter
- Editorial
- Multiple gestation: more research challenges to come
- Highlight articles - Multiples
- Fertility treatment and dichorionic discordant twins – are they related?
- Intertwin estimated fetal weight or crown rump length discordance and adverse perinatal outcome
- Prospective risk of intrauterine death of monochorionic twins: update
- Perinatal outcome of dichorionic-triamniotic as compared to trichorionic triplets
- Outcome of monochorionic-biamniotic twins conceived by assisted reproduction: a population-based study
- Neonatal morbidities and need for intervention in twins and singletons born at 34–35 weeks of gestation
- Glucose tolerance in singleton, twin and triplet pregnancies
- Respiratory morbidity in twins by birth order, gestational age and mode of delivery
- Neonatal outcomes of twin pregnancies delivered at late-preterm versus term gestation based on chorionicity and indication for delivery
- Original papers - Newborn
- Congenital diaphragmatic hernia – a Belgrade single center experience
- Iron homeostasis after blood transfusion in stable preterm infants – an observational study
- Detection and quantification of left-to-right shunting using transpulmonary ultrasound dilution (TPUD): a validation study in neonatal lambs
- Clinical utility of transcutaneous bilirubinometer (TcB) in very low birth weight (VLBW) infants
- Outcome of small for gestational age preterm singletons: a population-based cohort study
- Congress Calendar
- Congress Calendar