EP07.02: Maternal and neonatal outcomes in triplet pregnancies according to the mode of delivery

Abstract

The objective of this study was to compare the maternal and neonatal outcomes in triplet pregnancies according to the mode of delivery. Medical records were reviewed in triplet pregnancies who were delivered in the Seoul National University Hospital between Jan. 1997 and Jan. 2015. This case–control study included 18 triplet pregnancies with vaginal delivery (VD group) and 36 control triplet pregnancies with Caesarean delivery (CD group), matched for gestational age at delivery (1:2). In maternal outcomes, pre-eclampsia, gestational diabetes mellitus, preterm labour, preterm premature rupture of membrane, antenatal steroids and post-delivery transfusion were included. Neonatal outcomes included Apgar score, neonatal intensive care unit (NICU) admission, NICU stay duration, respiratory distress syndrome, bronchopulmonary dysplasia, intraventricular hemorrhage and periventricular leukomalacia and necrotising enterocolitis. Median gestational age at delivery was similar between the two groups (33.3 weeks in VD group vs. 33.2 weeks in CD group). CD group had a higher rate of nulliparous pregnant women than VD group (91.7% vs. 55.6%, p < 0.01). No significant differences in other demographic findings were found between the two groups. Maternal and neonatal outcomes were not different according to the mode of delivery, while the rate of low 5 min Apgar score (<7) was higher in CD group than VD group (18.5% vs. 1.9%, p < 0.01). These findings here in suggest that neonatal outcomes in vaginal delivery were comparable to those in Caesarean delivery. However, the retrospective case–control study design and the small sample size in this study may limit the generalisation of vaginal delivery as a possible option in triplet pregnancies.