Perinatal and obstetric outcomes of dichorionic vs trichorionic triplet pregnancies

Background Clinical management and outcome of multiple gestation can be affected by chorionicity. In triplet pregnancies, fetal death has been associated with dichorionic (DC) and monochorionic placentation. Studies evaluating triplet pregnancy outcomes in relation to chorionicity have been few and...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2016-05, Vol.214 (5), p.659.e1-659.e5
Main Authors: Lopes Perdigao, Joana, MD, Straub, Heather, MD, Zhou, Ying, PhD, Gonzalez, Anna, MD, Ismail, Mahmoud, MD, Ouyang, David W., MD
Format: Article
Language:English
Subjects:
Adult
Chicago - epidemiology
Chorion
chorionicity
Cohort Studies
Female
Fetofetal Transfusion - mortality
Gestational Age
Humans
Infant
Infant Mortality
Infant, Newborn
Infant, Very Low Birth Weight
Middle Aged
Obstetrics and Gynecology
perinatal and obstetric outcome
Pregnancy
Pregnancy, Triplet
Premature Birth - etiology
Retrospective Studies
triplets
Young Adult
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Summary:Background Clinical management and outcome of multiple gestation can be affected by chorionicity. In triplet pregnancies, fetal death has been associated with dichorionic (DC) and monochorionic placentation. Studies evaluating triplet pregnancy outcomes in relation to chorionicity have been few and may not reflect contemporary antenatal and neonatal care. Objective The objective of this study was to compare obstetric and perinatal outcomes in DC and trichorionic (TC) triplet pregnancies. Study Design We performed a retrospective cohort study of triplet pregnancies that delivered at ≥20 weeks’ gestation at 2 Chicago area hospitals from January 1999 through December 2010. Chorionicity was determined by pathology specimen. Maternal and infant charts were reviewed for obstetric and perinatal outcomes. Results The study population included 159 pregnancies (477 neonates) of which 108 were TC (67.9%) and 51 were DC (32.1%). Over 94% of mothers in this study had all 3 infants survive to discharge regardless of chorionicity. No difference was found in perinatal mortality rate between DC and TC triplets (3.3% vs 4.6%; P  = .3). DC triplets were significantly more likely to be very low birthweight (41.8% vs 22.2%; odds ratio, 2.2; 95% confidence interval, 1.2–4.2; P  = .02) and to deliver at
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2015.11.013