RESUMEN
With delayed childbearing and increased use of ovulation-stimulating drugs and assisted reproductive technologies (ART), the incidence of multiple pregnancies has increased dramatically in the past 20 years. One of the most common and serious complications of multiple pregnancies is preterm delivery. The delivery of the initial fetus in a multiple gestation usually is followed by the delivery of the subsequent fetus or fetuses shortly there after. However, a few successful delayed-interval deliveries have been reported since the first case in 1880 by Carson. Since that time, an interest in delayed-interval delivery has been developed and spurred by the increased prevalence of multiple gestations and preterm deliveries associated with these pregnancies. We report a case of a delayed-interval delivery in a twin pregnancy with an interval of 71 days. This case is the longest interval case and the fisrt delayed-interval delivery in monochorionic twin in Korea.
Asunto(s)
Femenino , Humanos , Embarazo , Feto , Incidencia , Corea (Geográfico) , Embarazo Múltiple , Embarazo Gemelar , Prevalencia , Conducta Reproductiva , Técnicas Reproductivas AsistidasRESUMEN
OBJECTIVE: To evaluate the perinatal outcomes and maternal complications associated with triplet pregnancies. METHODS: Medical records of consecutive triplet pregnancies delivered in ( )( )Hospital from 1997 to 2005 were reviewed for maternal and neonatal outcomes. Pregnancies associated with lethal congenital anomalies or the case that being delivered before 20 weeks of gestation were excluded. Neonatal outcomes included respiratory distress syndrome, retinopathy of prematurity, necrotizing enterocolitis, intraventricular hemorrhage and low Apgar scores, congenital anomaly and so on. Maternal outcomes included preeclampsia, preterm delivery, anemia and blood transfusion and so on. RESULTS: The mean gestational age at delivery was 31.5+/-4.1 weeks, and the mean birth weight for triplets was 1,654.4+/-578.1 g. 31 of total 39 neonates (79.5%) were admitted to the neonatal intensive care unit, and 9 neonates (23.1%) received mechanical ventilator care as well. Neonatal death occurred in 6 of 39 neonates (15.4%). Congenital anomaly was seen in 3 of 39 neonates (7.7%). Hyperbilirubinemia developed in 16 of 39 neonates (44.4%). Respiratory distress syndrome developed in 3 of 39 neonates (7.7%). The most common maternal complication was preterm labor (76.9%), followed by anemia (46.1%), preterm premature rupture of membrane (30.8%) and blood transfusion (7.7%). Five patients (5/13, 38.5%) received tocolytic therapy. CONCLUSION: The main cause of neonatal death in triplet pregnancies is the respiratory distress syndrome in extreme preterm delivery. The most common neonatal morbidities are hyperbilirubinemia and apnea of prematurity. There is no difference in neonatal outcomes according to birth order. The most common maternal complications are preterm delivery and anemia. The adverse outcomes of triplet pregnancies are mainly due to preterm delivery.
Asunto(s)
Femenino , Humanos , Recién Nacido , Embarazo , Anemia , Apnea , Orden de Nacimiento , Peso al Nacer , Transfusión Sanguínea , Enterocolitis Necrotizante , Edad Gestacional , Hemorragia , Hiperbilirrubinemia , Cuidado Intensivo Neonatal , Registros Médicos , Membranas , Trabajo de Parto Prematuro , Preeclampsia , Embarazo Triple , Retinopatía de la Prematuridad , Rotura , Tocólisis , Trillizos , Ventiladores MecánicosRESUMEN
OBJECTIVE: To evaluate the perinatal outcomes and maternal complications associated with triplet pregnancies. METHODS: Medical records of consecutive triplet pregnancies delivered in ( )( )Hospital from 1997 to 2005 were reviewed for maternal and neonatal outcomes. Pregnancies associated with lethal congenital anomalies or the case that being delivered before 20 weeks of gestation were excluded. Neonatal outcomes included respiratory distress syndrome, retinopathy of prematurity, necrotizing enterocolitis, intraventricular hemorrhage and low Apgar scores, congenital anomaly and so on. Maternal outcomes included preeclampsia, preterm delivery, anemia and blood transfusion and so on. RESULTS: The mean gestational age at delivery was 31.5+/-4.1 weeks, and the mean birth weight for triplets was 1,654.4+/-578.1 g. 31 of total 39 neonates (79.5%) were admitted to the neonatal intensive care unit, and 9 neonates (23.1%) received mechanical ventilator care as well. Neonatal death occurred in 6 of 39 neonates (15.4%). Congenital anomaly was seen in 3 of 39 neonates (7.7%). Hyperbilirubinemia developed in 16 of 39 neonates (44.4%). Respiratory distress syndrome developed in 3 of 39 neonates (7.7%). The most common maternal complication was preterm labor (76.9%), followed by anemia (46.1%), preterm premature rupture of membrane (30.8%) and blood transfusion (7.7%). Five patients (5/13, 38.5%) received tocolytic therapy. CONCLUSION: The main cause of neonatal death in triplet pregnancies is the respiratory distress syndrome in extreme preterm delivery. The most common neonatal morbidities are hyperbilirubinemia and apnea of prematurity. There is no difference in neonatal outcomes according to birth order. The most common maternal complications are preterm delivery and anemia. The adverse outcomes of triplet pregnancies are mainly due to preterm delivery.