Maternal and neonatal outcomes of attempted vaginal compared with planned cesarean delivery in triplet gestations

Background The prevailing obstetric practice of planned cesarean delivery for triplet gestations is largely empiric and data on the optimal route of delivery are limited. Objective The primary objectives of this study are to determine the likelihood of success in an attempted vaginal delivery and as...

Full description

Saved in:
Bibliographic Details
Published in:American journal of obstetrics and gynecology 2016-10, Vol.215 (4), p.493.e1-493.e6
Main Authors: Lappen, Justin R., MD, Hackney, David N., MD, MS, Bailit, Jennifer L., MD, MPH
Format: Article
Language:English
Subjects:
Blood Transfusion - statistics & numerical data
cesarean delivery
Cesarean Section
Cohort Studies
Delivery, Obstetric - methods
Female
Gestational Age
Humans
Infant, Newborn
Labor, Induced
multifetal gestation
Obstetrics and Gynecology
Pregnancy
Pregnancy Outcome
Pregnancy, Triplet
Respiration, Artificial
Retrospective Studies
route of delivery
triplet gestation
Triplets
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background The prevailing obstetric practice of planned cesarean delivery for triplet gestations is largely empiric and data on the optimal route of delivery are limited. Objective The primary objectives of this study are to determine the likelihood of success in an attempted vaginal delivery and assess maternal and neonatal outcomes of attempted vaginal vs planned cesarean delivery of triplets using a multiinstitution obstetric cohort. Study Design We performed a retrospective cohort study using data from the Consortium on Safe Labor, identifying triplet pregnancies with delivery at a gestational age ≥28 weeks. Women with a history of cesarean delivery and pregnancies complicated by chromosomal or congenital anomalies, twin-twin transfusion syndrome, or a fetal demise were excluded. The attempted vaginal group included all women with spontaneous or induced labor and excluded all women delivering by prelabor cesarean delivery, including those coded as elective or for fetal malpresentation. Primary maternal outcomes included infection (composite of chorioamnionitis, endometritis, wound separation, and wound infection), blood transfusion, or transfer to the intensive care unit. Primary neonatal outcomes included neonatal asphyxia, mechanical ventilation, and composite neonatal morbidity, consisting of ≥1 of the following: birth injury, 5-minute Apgar
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2016.04.054