Comparison of Obstetrical Outcomes in Booked and Unbooked Patients of Triplet Gestation

Abstract

Background. With the increasing use of assisted reproductive technologies and ovulation induction, the
rate of triplet pregnancies has increased dramatically. Multiple pregnancies are associated with greater
risks for both mother and fetuses compared with a singleton pregnancy. The aim of this study was to
evaluate if a simple intervention like antenatal care could improve obstetrical outcome in patients with triplet
pregnancy.
Methods. The study was conducted at the Department of Obstetrics and Gynaecology, Services Hospital
st st Lahore, from 1 January1998 to 31 December 2003. Twelve women, including 6 booked and 6 unbooked
patients, with triplet pregnancies of ≥ 24 weeks of gestation, who presented at the department, during the
study period, were studied. Obstetrical outcomes including length of fetal gestational age at delivery, birth
weights, apgar scores and neonatal assessment, admission in neonatal intensive care and stillbirths /
neonatal deaths were recorded.
Results. The average maternal age was 30.3 years and average maternal weight was 63.25 Kg. Ten
women had conceived by ovulation induction while two had conceived spontaneously. The average
gestational age at delivery in unbooked patients was 32 weeks and was 34.8 weeks in booked women.
Caesarean section was the preferred mode of delivery. However, two unbooked patients presented in
active labour at 29 and 30 weeks delivered vaginally. Among the booked patients 15 babies were live-born
with apgar score ≥ 7, two babies required admission, one baby died of sepsis in nursery and there were no
intrauterine deaths. Among the unbooked patients only 3 babies were live-born with apgar score ≥ 7, five
babies were admitted in neonatal nursery, 7 babies died in the first week of life and there were three
intrauterine fetal deaths.
Conclusion.Antenatal management improved the obstetrical outcome of triplet pregnancy