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Conservative management of triplet pregnancy after delivery of one foetus

Published online by Cambridge University Press:  21 February 2012

Jean-Marc Biard
Affiliation:
Department of Obstetrics, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Pierre Bernard
Affiliation:
Department of Obstetrics, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Karl Thomas
Affiliation:
Department of Obstetrics, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Corinne Hubinont*
Affiliation:
Department of Obstetrics, Cliniques Universitaires Saint-Luc, Brussels, Belgium. [email protected]
*
*Correspondence: C. Hubinont, Department of Obstetrics, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 1200 Brussels, Belgium. Tel: 00 32 2 764 10 14

Abstract

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This paper intends to demonstrate that the conservative management of triplet pregnancy after delivery of one foetus is a feasible and reasonable approach. Three cases of triplet pregnancy with successful conservative management after miscarriage of one foetus, are presented and compared with cases in the literature. The route of delivery, as well as the role of tocolysis, cerclage, prophylactic antibiotic therapy and corticosteroids are discussed. Guidelines for conservative treatment are proposed. The deliveries of our three pregnancies were delayed by 63, 44 and 22 days respectively. Foetal and neonatal evolution are normal in five of the remaining foetuses. Only one intrauterine death is observed. No maternal complications with sequelae are reported. After abortion of the first triplet, contractions often persist and the birth of the two remaining foetuses may be unavoidable. Nevertheless, in our experience, confirmed by some reports in the literature, prolongation of the pregnancy after expulsion of the first foetus is possible. It can be achieved by cervical cerclage associated with tocolytic and antibiotic therapy. This management is not associated with significantly increased foetal-maternal morbidity. Twin Research (2000) 3, 71–75.

Type
Articles
Copyright
Copyright © Cambridge University Press 2000