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Perinatal outcome of triplet gestation: does prophylactic cerclage make a difference?
MedLine Citation:
PMID:  10838335     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective: To compare the perinatal outcome of triplet gestations with and without prophylactic cerclage.Methods: A retrospective chart review of all triplet gestations delivered between January 1988 and June 1997 was performed. Only women initiating prenatal care before 15 weeks gestation were included. Management guidelines for triplets were uniform with the exception of use of prophylactic cerclage placed at 14 +/- 1 weeks gestation. Hospitalization was reserved for maternal medical and obstetric conditions, or fetal indications. Tocolytics were initiated only for persistent uterine contractions with intact membranes. All deliveries were effected by cesarean section at 37 weeks or less for maternal or fetal indications. All neonates were cared for at our institution. The cerclage group was compared to the no cerclage group for gestational age at delivery and maternal and neonatal complications. Descriptive statistics, Student t test, and Mann-Whitney U test were used for analysis.Results: Fourteen of the 51 (27.4%) sets of triplets had cerclage. There were no differences between groups when compared for maternal age, length of hospital stay, preterm labor rate, steroid use, histologic or clinical chorioamnionitis, and postoperative complications. In addition, there were no differences in mean birth weight, Apgar scores, respiratory distress syndrome, intraventricular hemorrhage/periventricular leucomalacia, NICU stay, and neonatal mortality. Although the mean gestational age at delivery for the cerclage group (33.1 +/- 2.7 weeks) was not different from the no cerclage group (31.7 +/- 3.7 weeks), the proportion of pregnancies delivered at 31 weeks or more was significantly higher in the cerclage group (13/14 vs 23/37, P =.03).Conclusions: Prophylactic cerclage may influence the proportion of triplet gestations delivered at 31 weeks or more. Lack of differences in the other parameters may be reflective of the small sample size.
Authors:
Elimian; Figueroa; Nigam; Verma; Tejani; Kirshenbaum
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Primary care update for Ob/Gyns     Volume:  5     ISSN:  -     ISO Abbreviation:  Prim. Care Update Ob Gyns     Publication Date:  1998 Jul 
Date Detail:
Created Date:  2000-06-05     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9431228     Medline TA:  Prim Care Update Ob Gyns     Country:  -    
Other Details:
Languages:  ENG     Pagination:  180     Citation Subset:  -    
Affiliation:
New York Medical College, New York, Valhalla, USA
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