Cross-sectional analysis of triplet birth weight

Article Abstract:

Evaluations of the growth of fetuses are based upon growth curves constructed for single fetuses and for twins. Multiple pregnancies are involved in 10 to 12 percent of all perinatal deaths and 17 percent of the cases of intrauterine growth retardation, while only 1 percent of all live births are from multiple pregnancies. In particular, triplet gestations may have mortality rates as high as 31 percent. Data concerning normal triplet growth in utero are needed. To construct growth curves for triplet fetuses, data from 196 triplet pregnancies (580 infants, another eight were stillborn) were analyzed. Growth curves were based on triplet weights at different gestational ages when the infants were delivered. In 103 cases, the date of fertilization (in vitro fertilization) or ovulation was known precisely. Results showed that the average gestational age at delivery was 33.6 weeks, with the average birth weight for each infant being 1,864 grams (4.1 pounds). Graphs are presented for triplet sets and for individual triplets. Triplet growth between 22 and 38 weeks' gestation was essentially linear, with a pattern similar to that of singleton fetuses through 30 weeks' gestation. After that point, triplets' weights continued to rise in a linear fashion, rather than accelerating, as in the case of singletons. There was considerable discordance (difference) among the weights of members of a triplet set; almost one-third of the cases had a discordance of 25 percent or more. This is considerably more discordance than is seen among twins. These data should be helpful for evaluating triplet growth and for diagnosing certain complications at an early stage. (Consumer Summary produced by Reliance Medical Information, Inc.)

Standards, Fetus, Growth, Birth weight, Fetal development, Triplets

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Quantification of cervical change: relationship to preterm delivery in the multifetal gestation

Article Abstract:

The examination of the cervix (the opening of the uterus) before birth may help to predict the onset of labor in pregnancies of more than one fetus. One study showed that the detection of an abnormality in the cervix earlier than 34 weeks of pregnancy was associated with an increased risk of early labor in pregnancies of twins. Prematurity is a major cause of death and disability during birth in multifetal pregnancies (pregnancies involving more than one fetus). Hence, a method to predict preterm labor would be beneficial in preventing associated complications. The effectiveness of examining the cervix before birth in determining the risk of preterm labor in multifetal pregnancies was assessed. Physical examination of the cervix was performed each week in 86 pregnancies of twins and seven pregnancies of triplets. The results of the physical examination were interpreted as a cervical score, which was calculated by subtracting the dilation of the cervix from the length of the cervix. A decrease in cervical score was associated with progression of pregnancy. Cervical scores that were zero or lower at 34 weeks or less of pregnancy predicted preterm delivery in 75 percent of cases. Preterm delivery occurred in only 2 of 78 pregnancies in which the cervical score was greater than zero at 34 weeks of pregnancy. These findings suggest that cervical examination before birth is a safe and effective method for determining the risk of premature birth in multifetal pregnancies. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Medical examination, Cervix uteri, Premature labor

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Cost-effective delivery management of the vertex and nonvertex twin gestation

Article Abstract:

The most cost-effective strategy for delivering twins in a vertex and nonvertex configuration may be breech extraction. Of 84 twin pair deliveries, 41 deliveries were vaginal and breech extracted, 19 births were vaginal after turning the baby, and 24 births were cesarean sections. Length of hospitalization and complications with attendant cost savings were lowest in the vaginal/breech extracted group although maternal health complications were similar across groups.

Evaluation, Economic aspects, Cost benefit analysis, Obstetrical extraction, Breech delivery, Breech birth

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