Document Detail


Perinatal outcome associated with outpatient management of triplet pregnancy.
MedLine Citation:
PMID:  9579454     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Our goal was to compare the lengths of hospitalization and the perinatal outcomes of triplet pregnancies managed with either outpatient or inpatient third-trimester bed rest. STUDY DESIGN: Thirty-two triplet pregnancies in which outpatient bed rest was prescribed (April 1993 to April 1996) were compared with a historic cohort of 34 triplets (January 1985 to March 1993) in which routine hospitalization was undertaken in the third trimester. Length of hospitalization and maternal and neonatal outcome parameters were compared between groups. RESULTS: Maternal inpatient hospital days were significantly reduced for the group managed as outpatients, but combined maternal and neonatal hospitalization was similar between groups. The mean gestational age at delivery was 1 week greater in the hospitalized cohort (33.5+/-2.8 vs 32.5+/-2.8, respectively; p=0.16), and average birth weight was correspondingly greater in hospitalized cases (1942 gm vs 1718 gm, p < 0.005). Neonatal lengths of stay were similar between groups, reflecting earlier postnatal discharge in the outpatient era of this study. Preeclampsia occurred with greater frequency in the outpatient group (31.3% vs 8.8%, p=0.02), and the neonatal complication of intraventricular hemorrhage occurred more commonly in this cohort as well (10/96 vs 1/102, p=0.004). All other maternal and neonatal complications were similar between groups. CONCLUSION: Reduction in the length of hospitalization attributable to outpatient management was limited to the maternal length of stay. It is possible that the observed maternal and neonatal complications in the outpatient group may have been related to less rigorous bed rest. We would suggest that the differences noted in preeclampsia, birth weight, and intraventricular hemorrhage support prospective evaluation of bed rest in triplet pregnancy.
Authors:
D M Adams; J S Sholl; E I Haney; T L Russell; R K Silver
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  178     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  1998 Apr 
Date Detail:
Created Date:  1998-05-22     Completed Date:  1998-05-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  843-7     Citation Subset:  AIM; IM    
Affiliation:
Division of Maternal-Fetal Medicine, Evanston Hospital, Northwestern University Medical School, Illinois 60201, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Bed Rest*
Birth Weight
Cerebral Hemorrhage / epidemiology
Cohort Studies
Female
Gestational Age
Humans
Infant, Newborn
Length of Stay
Pre-Eclampsia / epidemiology
Pregnancy
Pregnancy Outcome*
Pregnancy Trimester, Third
Pregnancy, Multiple*
Triplets*
Comments/Corrections
Comment In:
Am J Obstet Gynecol. 1999 Mar;180(3 Pt 1):771-2   [PMID:  10076161 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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