HEALTH OF WOMAN. 2016.5(111):37–40 
 

Triplet pregnancies in modern obstetrics 
 

Melnik O. V.

Shupyk National Medical Academy of Postgraduate Education, Kiev, Ukraine

This article provides information on triplet pregnancies, its features, risks and medical decisions. According to various authors, multiple pregnancy is about 3% of all pregnancies. triplets Pregnancy is often associated with a high risk for the mother and child, and more frequent contact with health professionals. Thus, a patient with a multiple pregnancy is high risk with regard to the development of maternal and perinatal complications.

Key words: triplets, multiple pregnancy, assisted reproductive technologies, intrapartum risks.

REFERENCES

1. Baeva IJ. 2005. The Anatomical metrical characteristic of born and newborn twins at multipara pregnancy. autrf. diss. cand. medical sciences. М:23.

2. Zharova AA. 2011. A condition fetiplacental complex and perinatal outcomes at multipara pregnancy. autrf. diss. cand. medical sciences. М:31.

3. Juldasheva OE. 2007. Features of conducting multipara pregnancy, an estimation of labours and perinatal outcomes. autrf. diss. cand. medical sciences. Ufa:24.

4. Adams DM. 2012. Perinatal outcome associated with outpatient management of triplet pregnancy. American Journal of Obstetrics and Gynecology 178:(4):843–847.

5. Behr B. 2013. Blastocyst-ET and monozygotic twinning. J. Assist Reprod Genet. 17:349-351. http://dx.doi.org/10.1023/A:1009461213139; PMCid:PMC3455394

6. Bernasko J. 2011. Is routine prophylactic cervical cerclage associated with significant prolongation of triplet gestation? Journal of Maternal-Fetal and Neonatal Medicine 19(9):575-578.

7. Caritis SN. 2009. Prevention of preterm birth in triplets using 17 alpha-hydroxyprogesteronecaproate: a randomized controlled trial. Obstetrics and Gynecology 113(2 Pt 1):285-292.

8. Combs CA. 2010. Failure of 17-hydroxyprogesterone to reduce neonatal morbidity or prolong triplet pregnancy: A double-blind, randomized clinical trial. American Journal of Obstetrics and Gynecology 203(3):248. http://dx.doi.org/10.1016/j.ajog.2010.06.016; PMid:20816146

9. Conde-Agudelo A. 2009. Antenatal magnesium sulfate for the prevention of cerebral palsy in preterm infants less than 34 weeks’ gestation: a systematic review and metaanalysis. Am. J. Obstet. Gynecol. 200:595–609. http://dx.doi.org/10.1016/j.ajog.2009.04.005; PMCid:PMC3459676

10. Conde-Agudelo A. 2009. Antenatal magnesium sulfate for the prevention of cerebral palsy in preterm infants less than 34 weeks’ gestation: a systematicreview and metaanalysis. Am. J. Obstet. Gynecol. 200:438-441. http://dx.doi.org/10.1016/j.ajog.2009.04.005; PMCid:PMC3459676

11. D'Amore A. 2014. The effect of antenatal corticosteroids on fetal growth, survival, and neurodevelopmental outcome in triplet pregnancies. American Journal of Perinatology 21(1):1-8.

12. Daw E. 1978. Triplet pregnancy. British Journal of Obstetrics and Gynaecology 85(7):505–509. http://dx.doi.org/10.1111/j.1471-0528.1978.tb15623.x

13. De Paepe ME. 2015. Vascular distribution patterns in monochorionic twin placentas. Placenta 46(6):471–475.

14. Dessolle L. 2010. Monozygotic triplet pregnancies after single blastocyst transfer: Two cases and literature review. Reprod Biomed Online. 21:283–289. http://dx.doi.org/10.1016/j.rbmo.2010.04.011; PMid:20638341

15. Devine PC. 2011. Maternal and neonatal outcome of 100 consecutive triplet pregnancies. American Journal of Perinatology 18(4):225–235. http://dx.doi.org/10.1055/s-2001-15505

16. Dodd JM. 2012. Oral betamimetics for maintenance therapy after threatened preterm labour. Cochrane Database Syst. Rev. 12:112-117. http://dx.doi.org/10.1002/14651858.cd003927.pub3

17. Doyle LW. 2009. Magnesium sulphate for women at risk of preterm birth for neuroprotection of the fetus. Cochrane Database Syst. Riews 16:114-120. http://dx.doi.org/10.1002/14651858.cd004661.pub3

18. Duyos Mateo I. 2013. Fetal complications and early neonatal outcomes on 147 triplets. Ginecol. Obstet. Mex. 81(2):86–91.

19. Elimian A. 2014. Perinatal outcome of triplet gestation: Does prophylactic cerclage make a difference. Journal of Maternal-Fetal Medicine 8(3):119. http://dx.doi.org/10.1002/(SICI)1520-6661(199905/06)8:3<119::AID-MFM9>3.0.CO;2-O; http://dx.doi.org/10.3109/14767059909020472

20. Guilherme R. 2009. Ultrasound assessment of the prognosis in triplet pregnancies. Acta Obstetricia et Gynecologica Scandinavica 88(4):386–390. http://dx.doi.org/10.1080/00016340902792433

21. Guzman ER. 2013. Use of cervical ultrasonography in prediction of spontaneous preterm birth in triplet gestations. American Journal of Obstetrics and Gynecology 183(5):1108–1113. http://dx.doi.org/10.1067/mob.2000.108875

22. Henne MB. 2013. Monochorionic triplet gestation after in vitro fertilization using donor oocytes: Case report and review. Fertil Steril. 83:742–748. http://dx.doi.org/10.1016/j.fertnstert.2004.11.004; PMid:15749508

23. Jain JK. 2014. Monozygotic twins and triplets in association with blastocyst transfer. J. Assist. Reprod. Genet. 21:103–107. http://dx.doi.org/10.1023/B:JARG.0000029493.54929.be

24. Kaufman GE. 2011. Neonatal morbidity and mortality associated with triplet pregnancy. Obstetrics and Gynecology 91(3):342–348. http://dx.doi.org/10.1016/S0029-7844(97)00686-8

25. Khodzhaeva Z. 2009. Experience with cervical serclage in multiple pregnancies. J. Maternal-Fetal & Neоnatal Medicine 21:67-72.

26. Li Y. 2009. Dichorionic quadramniotic quadruple gestation with monochorionictriamniotic triplets after two embryos transfer and selective reduction to twin pregnancy: case report. Fertility and Sterility 92(6):489-496. http://dx.doi.org/10.1016/j.fertnstert.2009.08.022; PMid:19818440

27. Manso P. 2011. Chorionicity and perinatal complications in twin pregnancy: a 10 years case series. Acta Med. Port. 24(5):695–698.

28. Maslovitz S. 2014. Cervical length in the early second trimester for detection of triplet pregnancies at risk for preterm birth. Journal of Ultrasound in Medicine 23(9):1187–1191.

29. Mordel N, Zajicek G, Benshushan A. 2013. Elective suture of uterine cervix in triplets. American Journal of Perinatology 10(1):14–16. http://dx.doi.org/10.1055/s-2007-994691; PMid:8442790

30. Nicolaides K. 2008. Ultrasound pregnancy research in 11–13 weeks of pregnancy. Stb:238.

31. Norman JE, Mackenzie F, Owen P. 2009. Progesterone for the prevention of preterm birth in twin pregnancy (STOPPIT): a randomised, double-blind, placebo-controlled study and meta-analysis. Lancet. 373:2034–2040. http://dx.doi.org/10.1016/S0140-6736(09)60947-8

32. Paulson RJ, Boostanfar R, Saadat R. 2012. Pregnancy in the sixth decade of life. Obstetric outcomes in women of advanced reproductive age. JAMA. 288:2320-2323.

33. Rebarber A, Roman AS, Istwan N. 2015. Prophylactic cerclage in the management of triplet pregnancies. American Journal of Obstetrics and Gynecology 193(3 Pt 2):1193-1196.

34. Salat-Baroux J, Alvarez S, Antonie JM. 2014. A case of triple monoamniotic pregnancy combined with a bioamniotic twinning after in-vitro fertilization. Human Reproduction 9(2):374–375.

35. Sanchez Ramos L, Kaunitz AM, Delke I. 2012. Progestational agents to prevent preterm birth: a me-ta-analysis of randоmized controlled trials. Obstet. Gynecol. 10:273–279.

36. Schaap AH, cvan den Wingaard JP. 2014. Significance of donor anuria differs between monoamniotic and diamniotic twin-twin transfusion syndrome. Placenta 28:523–526.

37. Sebire N, Snijders R, Hughles K. 2012. The hidden mortality of monochorionic triplet pregnancies. Br. J. Obstet. Gynecol. 104:1203–1207. http://dx.doi.org/10.1111/j.1471-0528.1997.tb10948.x

38. Shek NW, Hillman SC. 2013. Single-triplet demise: Pregnancy outcome. Best. Pract. Res. Clin. Obstet. Gynaecol. 3:132-136.

39. Sills ES, Moomjy M, Zaninovic M. 2014. Human zonapellucida micromanipulation and monozygotic twinning frequency after IVF. Hum Reprod. 15:890-895. http://dx.doi.org/10.1093/humrep/15.4.890

40. Steen EE, Kallen K, Marsal K. 2013. Impact of sex on perinatal mortality and morbidity in triplets. J. Perinat. Med. 12:10-15.

41. Su LL, Samuel M. 2010. Progestational agents for treating threatened or established pre-term labour. Cochrane Database Syst. Reviews 1:19-23.

42. Suzuki S, Okudaria S, Sawa R. 2013. Characteristics of monochorionic-diamniotic growth-retarded twins during the third trimester. Nippon Ika Daigaku Zasshi. 66(5):300–304. http://dx.doi.org/10.1272/jnms.66.300

43. TAMBA. Multiple Failings. Parents of Twins and Triplets Experience of Pre and Post Natal NHS Care (TAMBA Health and Lifestyle Survey 2008) Guildford: Twins and Multiple Births Association. 2009:321.

44. Vis JY, Wilms FF, Oudijk MA. 2009. Cost-effectiveness of fibronectin testing in a triage in women with threatened preterm labor: alleviation of pregnancy outcome by suspending tocolysis in early labor (APOSTEL-I trial). BMC Pregnancy Childbirth. 19:38.

45. Wadhawan R, Oh W, Vohr BR. 2013. Spontaneous intestinal perforation in extremely low birth weight infants: association with indometacin therapy and effects on neurodevelopmental outcomes at 18-22 months corrected age. Arch. Dis. Child. Fetal. Neonatal. Ed. 98(2):127–132.

46. Yamasmit W, Chaithongwongwatthana S, Tolosa JE. 2012. Prophylactic oral betamimetics for reducing preterm birth in women with a twin pregnancy. Cochrane Database Syst. Rev. 12:32-39. http://dx.doi.org/10.1002/14651858.cd004733.pub3

47. Zork N, Biggio J, Tita A. 2013. Decreasing prematurity in triplet gestations: predicaments and possibilities. Obstet. Gynecol. 122(2 Pt 1):375–379.