A study was conducted on twinning in relatives of consecutive triplet sets in the Aland Islands in the years 1740-1939. The incidence of twinning in sibships of triplets was extremely high, 80/1000 (56/1000 before and 143/1000 after the triplet maternity). In Finland as a whole, 1905-1954, the twinning rate was ...

A case is reported of a transfusion syndrome in a triplet pregnancy with intrauterine death of two of the fetuses. This is an exceptional occurrence in a triplet pregnancy and raises the problem of the management of multiple pregnancies associated with the death of one or more of the fetuses. ...

Spontaneous bowel obstruction in pregnancy is a rare event and usually associated with a prior history of surgical procedures or infection. Its symptoms can mimic physiologic changes in pregnancy or preterm labor. We treated a woman who had a triplet gestation and whose lack of predisposing factors delayed the diagnosis ...

During the period 1975 to 1988, 78 triplet pregnancies that reached a gestational age greater than or equal to 20 weeks were treated in our department--a prevalence of 1/849 deliveries. A total of 69 (88%) of the pregnancies occurred after treatment with ovulation-induction agents. The most common complication of pregnancy ...

The course of gestation and the outcome of fifteen triplet and six quadruplet pregnancies are reviewed. Twenty pregnancies followed induction of ovulation and only one was spontaneous. Bed rest, the use of beta-mimetics and betamethasone, and prolonged hospitalisation were part of the management. Elective cervical suture was not used. The ...

Selective fetal reduction was performed in the first trimester of pregnancy in 20 women with multifetal gestations after ovulation induction with human menopausal gonadotropin (hMG). In 10 women (group A) reduction was performed transabdominally, and in 10 women (group B) the transvaginal approach was used. The transvaginal technique achieved penetration ...

The antepartum management of 198 women who were delivered of triplets between 1985 and 1988 is reviewed. Women were managed with the assistance of ambulatory perinatal nursing to provide outpatient surveillance. Modified bed rest, prophylactic tocolysis, and betamethasone were liberally used and patients were hospitalized only when obstetrically indicated. The ...

As new advances in the treatment and management of infertility become available, it is hoped that selective reduction procedures will no longer be necessary. In the interim, however, it is imperative that nurses be knowledgeable about the options available to parents experiencing multifetal pregnancy, including the choice of selective reduction ...

The main complication in multiple gestation with more than two fetuses is prematurity, with its concomitant increase in perinatal mortality and morbidity. Clearcut indications as to management of these pregnancies are lacking, and the efficiency of elective cerclage is controversial. Twelve triplets and three quadruplets out of 27 multiple pregnancies ...

The incidence of multiple conceptions is higher than the incidence of multiple deliveries. The "vanishing fetus" is a relatively new concept being a direct result of the advent of ultrasonography. Early first trimester loss of one or more conceptuses accounts for this phenomenon. The patient may be symptomatic (bleeding, pain, ...

Pregnancy outcomes were compared between a stratified random sample of 796 women delivering a live birth at a maternity center (BMC) and a frequency matched sample of 804 women delivering a live birth at a tertiary hospital (TJUH) in 1977-1978. The relationship of use of obstetric procedures with pregnancy outcomes ...

With the increase of medical induction of ovulation, the incidence of grand multiple pregnancy is becoming more frequent. We report the endocrine response of a quintuplet pregnancy that was reduced at 9 weeks' gestation to a twin pregnancy by selective embryocide and compared with quadruplet, triplet, and twin pregnancies. The ...

The acardiac monster represents one of the most severe but rare congenital anomalies. It occurs only in multiple gestations associated with vascular anastomoses between the affected fetus and its co-twin. The prenatal diagnosis of an acardiac fetus must be suspected in any multiple gestation in which cardiac activity cannot be ...

The grief process is examined within the framework of multifetal pregnancy in a variety of demise situations. The case studies examined were obtained from approximately 120 letters and interviews with families predominantly of higher order multiple births, who have experienced either partial or total loss in their pregnancy or afterwards. ...

The frequency of triplets in the U.S. white population may have reached an all-time low around 1964, at 78 sets per million deliveries. One-fourth of those were monozygotic as estimated by the difference method, or 18% by Bulmer's theoretical model. By 1983 the frequency of triplets had nearly doubled, the ...

The birthweights and placental weights of 3000 singletons, 1500 twin pairs and 67 triplets are studied in relation to the gestational age. From 30-32 weeks onwards, newborns of twin- and triplet gestation show lower birthweight as compared to singleton newborns. Placental indices (placental weights related to birthweights) are about alike ...

We examined the effectiveness of a bubble helmet and differential reinforcement procedures in the treatment of the self-injurious behavior (SIB) of three adult residents of a state hospital for the developmentally disabled. A multiple-baseline design across settings and an ABC design were used to assess the effectiveness of these procedures. ...

An analysis of 25 perinatal malpractice cases filed in Wisconsin between 1978 and 1984 clearly revealed that the unfavorable outcomes were preventable and caused by professional negligence. Each case was settled or adjudicated in favor of the plaintiff, and the awards totaled $25.1 million. Although cases with a total recovery ...

The twinning rate remained nearly constant up to 1968, then decreased in 1974 and gradually increased with the year. The triplet birth rate remained nearly constant up to 1974, then increased up to 1982, where the rate was 1.8 times higher than in 1968, and decreased thereafter. On the other ...

Two cases occurred of a delayed interval between the second-trimester delivery and abortion of a nonviable fetus from a multifetal gestation with a surviving fetus or fetuses. In twin pregnancy, there was a 23-day interval between the delivery of twin A (at 21 weeks) and of twin B (at 24 ...

Triplet pregnancy is an uncommon event. The chance that one or more fetuses will suffer intrauterine death in such a pregnancy is one in six, yet the mechanism of those fetal deaths is poorly understood. This paper reports on the delivery of a surviving triplet after the demise, many weeks ...

Details of 767 clinical pregnancies and 500 births from Bourn Hall are reported. All treated patients included some over 40 years old, many with ovarian or uterine defects, male infertility, etc. Patients were treated during their natural cycle or stimulated with clomiphene or clomiphene and human menopausal gonadotrophin. Follicular maturation ...

The twinning, triplet and quadruplet rates were found to be 23.8, 0.3 and 0.04 per thousand maternities, respectively in a survey of 71,773 maternities carried out in Ibadan and Igbo Ora, Nigeria. This represents a dramatic fall from the rates found in previous studies. The findings are discussed in the ...

A fertilisation cohort of 244 pregnancies resulting from in vitro fertilisation was reported to a national register by eight units specialising in in vitro fertilisation. Early pregnancy losses were high, with 5% tubal ectopic pregnancies, 18% biochemical pregnancies, and an incidence of spontaneous abortion of 27%. Among pregnancies of at ...

A pregnant patient with irreversible anoxic brain damage was maintained by life-support measures from 14 weeks' gestation until delivery of a healthy male infant at 34 weeks. Because two patients (the mother and the fetus), as well as the surviving family members, will be affected by decisions about life support, ...

Triplet pregnancy of over 20 weeks gestation occurred 20 times during 75,506 deliveries at a referral hospital. Commonly occurring maternal complications included premature delivery (75%), antepartum anemia (35%), postpartum hemorrhage (35%), preeclampsia (20%), and premature spontaneous rupture of the membranes (20%). Malpresentation was common. Neonatal complications were also common and ...

A triplet pregnancy is described in which there was a second trimester abortion of one fetus at 16 weeks' gestation. A cervical cerclage was placed, and tocolysis was used. The other two triplets were delivered 131 days later (at 35 weeks' gestation) by cesarean section. Both infants survived. This case ...

A case report of delayed delivery of 99 days in a triplet pregnancy is presented. A triplet pregnancy in a single uterus resulted from Pergonal stimulation of ovulation. At 23.5 weeks' gestation, the first triplet delivered after spontaneous rupture of membranes. Ninety-nine days later, the remaining two fetuses were delivered, ...

Questionnaires were sent to 452 hospitals in the RSA and SWA/Namibia requesting information on triplet pregnancies over a 10-year period. Information on 367 sets of triplets from 150 hospitals was adequate for analysis. The incidence of triplets was 0,04% of all deliveries. As many as 45% of triplets were diagnosed ...

Postdate pregnancy is estimated to occur in 3% to 12% of all gestations. Morbidity and mortality rates associated with this common obstetric problem are higher than those with term gestation. The incidence of fetal distress, birth injury, meconium aspiration, congenital malformations, macrosomia, and oligohydramnios is also greater in postdate pregnancy. ...

Thirty-one genetic amniocenteses involving multiple gestations were performed in the genetics unit between 1976 and 1982. Three sets of triplets were included. Precise locations of the sacs were determined using real-time ultrasonography and successful sampling of all sacs was accomplished. Spontaneous abortions occurred in two normal twins and one normal ...

A 38-year-old woman, gravida 5, para 3, with a triplet pregnancy discordant for anencephaly, is reported. The diagnosis was made prenatally by ultrasound. Autopsy of the anencephalic member revealed small adrenal glands with absent fetal cortex, and a coincidental tetralogy of Fallot. Studies of the histocompatible lymphocyte antigens of both ...

The rates of MZ and DZ twin births and of triplet births slightly decreased in Japan in 1955-1967 and 1974, whereas that of trizygotic triplets tripled. The rates of triplet and quadruplet births were comparable to those of Caucasians. Although the sample size is small, Japan seems to be characterized ...

An analysis is made of the management and outcome of 35 pregnancies involving triplets, quadruplets, and quintuplets. Bed rest does not seem to increase the gestational age at the time of delivery but definitely improves the fetal outcome. Administration of betamethasone as early as 24 to 26 weeks' gestation to ...

The course of gestation and labor and the outcome of 31 triplet pregnancies were analyzed. Early diagnosis is very important for improving the rate of fetal salvage in multiple pregnancy. The outcome of triplet pregnancies was better in the group of patients with induced ovulation than in the group with ...

A patient with a triplet pregnancy had one infant affected by anencephalus. This pregnancy resulted from ovulation stimulation by gonadotropins. Several cases of association between anencephalus and induction of ovulation by clomiphene have been reported. The association with gonadotropins, however, has been reported only once. The event was prenatally diagnosed ...

A unique case of triplet pregnancy in a woman with uterus didelphys is described, with fetuses A and B in the right uterine horn and fetus C in the left horn. Missed abortion of fetus A was diagnosed in the 22nd week of gestation by real-time ultrasonography, but only in ...

The incidence of multiple gestation has increased as a result of ovulation stimulation in recent years. The early diagnosis by ultrasonography of the quintuplet gestation and the institution of special treatment to prevent the most common complications are discussed. The patient was delivered of five male infants at caesarean section ...

A retrospective analysis of 20 triplet pregnancies not stimulated by clomiphene or gonadotrophins revealed a perinatal mortality of 26.3%. There were greater losses recorded in the case of mothers who had received no antenatal care than for those who had been seen before the babies' births. Triplet pregnancy in this ...

The rate of multiple pregnancies with more than 2 fetuses has significantly increased since the introduction of ovulation induction agents. From 1970 through 1978, there were 19 triplets and 6 quadruplets in the authors' department, incidences of 1:696 and 1:5370, respectively. Eighteen (72%) of the 25 multiple pregnancies followed treatment ...

Analysis of 27 consecutive triplet pregnancies seen at the University Teaching Hospital in Enugu, Nigeria, from 1972 to 1979 revealed an incidence of one in 1014 live births; three of these mothers had had a previous twin pregnancy. Overall fetal mortality was 30.9%, with babies of older women faring better ...

A series of 61 triplet pregnancies delivered in the Baragwanath Hospital for the 10 years 1967 - 1976 is analysed, the incidence being 1 : 2 789 deliveries. The average maternal age was 29,6 years, and average parity 3,7; 60% had had adequate antenatal care, a figure significantly higher than ...

I report a review of 1500 pregnant patients: 30 of them (or 1 in 50) were thought to have multiple pregnancies when examined by ultrasound in the first trimester. Only 14 of the 30 patients (46.7 per cent) produced live infants: 13 twins and one set of triplets. Twelve (40 ...

The outcome of 59 triplet pregnancies from four hospitals was analyzed. The combined stillbirth and neonatal mortality rate was 232/1000. Preterm labour and birth order were the most important identifiable factors in relation to neonatal death. Birth weight within a triplet set and malpresentation were not related to neonatal death. ...

This study included a group of 50 women with amenorrhea-galactorrhea who were treated with bromocriptine (2-bromo-alpha-ergocryptine). Forty-two of these patients ovulated, and 36 conceived within 8 months of treatment. The pregnancies of 30 women reached a duration of 20 weeks or longer following ovulation induced by bromocriptine. Except in 1 ...

Birth defects associated with phenytoin and phenobarbital taken during pregnancy include craniofacial and limb deformities. These anomalies were found in various degrees of severity in triplets born to a mother taking phenobarbital and phenytoin for an epileptic disorder, giving us a unique opportunity to recognize different manifestations of the hydantoin ...

A series of 14 triplet pregnancies has been analyzed. The older triplet mother had a better chance of fetal survival than the younger mother. Parity did not appear to have much effect on fetal survival but the maturity of the infants at birth had more influence than did birth weight, ...

The analysis of the data from this study, though not complete, has shown the following: 1) High rates of plural births may be expected in Ghanaian populations (3.21% for twins, 0.05% for triplets). 2) Hellin's law relating to the incidence of multiple births has been found to apply to a ...

One hundred and ten women conceived 143 times following induction of ovulation by gonadotrophins. The abortion rate was 21 per cent. Some bleeding occurred in 38-7 per cent of pregnancies and 54 per cent of them ended in abortion. For the 112 pregnancies reaching 20 weeks, the multiple pregnancy rate ...

A 26-year-old subfertile woman with a history of abortions at the 7-9th week was treated with Clomid, 50 mg for 5 days. A pregnancy resulted, which ended in the premature birth of a set of alive triplets that sex and blood-group determinations showed to be trizgotic. It is suggested that ...