Multifetal Pregnancies.* Should a mother anticipate an earlier delivery if she is carrying more than one baby? This analysis of all 6,020,542 singleton infants and all 88,936 infants born of multifetal pregnancies in Japan between 1989 and 1993 suggests that she should. All analyzed pregnancies had progressed to at least 26 weeks' gestation. Only 4.2% of the women with singleton pregnancies gave birth before 37 weeks, versus 37.7% of women with multifetal pregnancies. Rates of completion of 40 weeks of gestation were 40.3% for singleton and 6.6% for multifetal pregnancies. The mean gestations were 39.1 and 36.5 weeks, respectively. In multifetal pregnancies, rates of stillbirth Stillbirth Definition A stillbirth is defined as the death of a fetus at any time after the twentieth week of pregnancy. Stillbirth is also referred to as intrauterine fetal death (IUFD). and early neonatal death were lowest when births took place at 37 to 38 weeks and were higher for births before and after that period. --Journal of the American Medical Association American Medical Association (AMA), professional physicians' organization (founded 1847). Its goals are to protect the interests of American physicians, advance public health, and support the growth of medical science. , 5/8/96 * The risks of triplets: With the increasing use of assisted reproductive technologies, the reported incidence of triplet triplet /trip·let/ (trip´let) 1. one of three offspring produced at one birth. 2. a combination of three objects or entities acting together, as three lenses or three nucleotides. 3. pregnancies is now I in 849 to 1 in 2083 pregnancies. (Natuarally occurring triplets are 1 in 10,000, contrary to a typo in the last issue of Special Delivery which placed the incidence at 1 in 10,000,000.) This report reviews 61 triplet deliveries from 1989 to 1994 at one Illinois institution. Three patients who gave birth before 20 weeks and one who delivered at 25 weeks were excluded. For the remaining 57, the mean gestational age at delivery was 33 weeks (plus or minus 2.7) with a mean birth weight of approximatley four pounds. The perinatal mortality rate was 41/1000 as compared with 12.2/1000 for all births in the state. Eighty-six percent of mothers had preterm labor, and 33% had preeclampsia preeclampsia /pre·eclamp·sia/ (pre?e-klamp´se-ah) a toxemia of late pregnancy, characterized by hypertension, proteinuria, and edema. pre·e·clamp·si·a n. . Additional severe complications included HELLP syndrome (hemolysis hemolysis (hĭmŏl`ĭsĭs), destruction of red blood cells in the bloodstream. Although new red blood cells, or erythrocytes, are continuously created and old ones destroyed, an excessive rate of destruction sometimes occurs. , elevated liver enzymes, and low platelets) in 10.5% and postpartum hemorrhage severe enough to require transfusion in 12.3%. One patient underwent a cesarean hysterectomy after massive blood loss. Mothers were hospitalized for a mean of 22 (plus or minus 16) days (mostly for possible preterm delivery), and 63% of infants were admitted to the neonatal ICU ICU intensive care unit. ICU abbr. intensive care unit ICU see intensive care unit. ICU . The most common neonatal complication was respiratory distress, in 50% of infants, and 7.1% had major congenital anomalies. --American Journal of Obstetrics and Gynecology obstetrics and gynecology Medical and surgical specialty concerned with the management of pregnancy and childbirth and with the health of the female reproductive system. , May 1996 |
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