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Perinatal outcome of dichorionic-triamniotic as compared to trichorionic triplets

  • Teresinha Simões , Alexandra Queiros , Margarida Rosal Gonçalves , Isabel Periquito , Patricia Silva and Isaac Blickstein EMAIL logo
Published/Copyright: October 24, 2015

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.


Corresponding author: Isaac Blickstein, Deptartment of Obstetrics and Gynecology, Kaplan Medical Center, 76100 Rehovot, and the Hadassah-Hebrew University School of Medicine, Jerusalem, Israel, Tel.: +972-545-201789, Fax: +972-89411944, E-mail: ; and Department of Maternal-Fetal Medicine and Neonatology, Maternity Dr. Alfredo da Costa, Centro Hospitalar Lisboa Central and Universidade Nova de Lisboa, Lisbon, Portugal

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.2005.01.007Search 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.Search 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/den364Search in Google Scholar PubMed

[4] De Catte L, Camus M, Foulon W. Monochorionic high-order multiple pregnancies and multifetal pregnancy reduction. Obstet Gynecol. 2002;100:561–6.10.1097/00006250-200209000-00026Search 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.2010.05.032Search 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;34:199–205.10.1159/000356170Search 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.2004.05.083Search 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.2002.122097Search 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.xSearch 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.2005.08.009Search 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.2013.03.003Search 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.2008.03.002Search 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)80282-0Search in Google Scholar

[14] Volpe JJ. Neurology of the newborn. 4th ed. Philadelphia: WB Saunders; 2001. p. 428–93.Search 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)80189-5Search 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)70413-2Search 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;60:1–70Search 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.13369Search 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;23:361–510.3109/14767050903177201Search 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.4357Search 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;35:83–6.10.1159/000356950Search 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.2003.08.046Search in Google Scholar PubMed

  1. The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2015-7-11
Accepted: 2015-9-15
Published Online: 2015-10-24
Published in Print: 2016-11-1

©2016 Walter de Gruyter GmbH, Berlin/Boston

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