Case Of Triplet Pregnancy Research Articles

Triplet pregnancy with severe preeclampsia: appropriate management

Introduction: The case of preeclampsia and triplet pregnancy is likely to cause hypertension in uncontrolled pregnant women if they are not managed properly, which may harm both the mother and the fetus. References for the treatment of similar cases are still uncommon. Therefore, this case study provides an overview of midwifery care management on cases of triplet pregnancy and severe preeclampsia.Case presentation: A case of exacerbated triplet pregnancy with severe preeclampsia is described in a 36-year-old woman who was recently detected at the third-trimester visit at 31 weeks four days' pregnancy.Conclusion: Management of patients with triplet pregnancies and severe preeclampsia is to perform standard antenatal care, ultrasound examinations in each trimester, hospital care, as well as psychological assistance.

Prophylactic Cervical Cerclage versus Vaginal Progesterone in Triplet Pregnancy—A Randomized Prospective Comparative Study

Objective: To compare the effect of prophylactic cervical cerclage with vaginal progesterone in triplet (with normal cervical measurements) to evaluate its efficacy in improving pregnancy outcome and prolonging gestation. Design: A randomized prospective comparative study. Setting: At Tanta university hospitals and outpatient clinics. Patients: 51 selected cases of triplet pregnancy were recruited and classified into 2 groups randomly, progesterone group (n = 28 cases) and cerclage group (n = 23 cases). Interventions: Transvaginal ultrasound was done for number of fetuses, viability, cervical measurements, vaginal progesterone for progesterone starting at 20 weeks, and applying McDonald cerclage at 14 - 16 weeks for cerclage group. Main Outcome Measures: Time of occurrence of preterm labor, premature rupture of membranes (PROM), stitch removal, gestational age at delivery, mode of delivery, and neonatal complications. Results: Preterm labor occurred in 9, 8 cases and PROM in 4, and 3 cases in progesterone and cerclage groups respectively. The mean gestational age was 33.57 ± 2.97 and 31.74 ± 3.21 weeks in progesterone and cerclage groups; mean birth weight was 2049 ± 591 gm, and 1686 ± 512 gm in progesterone and cerclage groups respectively; Apgar score 7 or more was found in 52 (60.8%), and 39 (56.3%) newborn in progesterone and cerclage group respectively. Perinatal mortality was lower in progesterone group 26.1% (3 IUFD+19 neonatal) than in cerclage group 30.4% (2 IUFD + 19 neonatal). Respiratory distress syndrome (RDS) occurred in 43.9%, 49.76%, while need of mechanical ventilation occurred in 12.2%, 16.41% of progesterone and cerclage groups respectively and neonatal jaundice was found in 49.38%, 53.7% of progesterone and cerclage groups respectively. Conclusion: Vaginal progesterone seems to be more effective than prophylactic cerclage in reducing preterm delivery in triplet pregnancies with normal cervical measurements even in those with prior history of preterm labour and minimizing neonatal morbidity and mortality.

Triplet pregnancy with partial hydatidiform mole coexisting with two fetuses: A case report

Hydatidiform mole with a coexistent fetus is rare, but this condition has recently shown an increased incidence because of assisted reproduction technology. Herein, we report on a case of triplet pregnancy with a partial hydatidiform mole coexisting with two fetuses. It was diagnosed by p57(kip2) immunohistochemical staining which is helpful in determining histologically equivocal cases. After termination of pregnancy, the patient was diagnosed with persistent gestational trophoblastic disease. Six courses of methotrexate chemotherapy were performed. Her beta-human chorionic gonadotrophin titers then fell to a normal level.

Pretreatment with oral contraceptives in infertile anovulatory patients with polycystic ovary syndrome who receive gonadotropins for controlled ovarian stimulation

This study was intended to assess the effects of oral contraceptives given before treatment in infertile anovulatory patients with polycystic ovary syndrome who receive gonadotropins for controlled ovarian stimulation. Pretreatment with oral contraceptives increased the mono-ovulatory cycles, the duration of stimulation for noncanceled cycles, and the number of vials of gonadotropins used. It also reduced the number of dominant follicles and the peak E(2) levels for dominant follicles. No effect was observed in rates of cycle cancellation, pregnancy, abortion, live birth, multiple pregnancies, and ovarian hyperstimulation syndrome.

A case of triplet pregnancy with IVF-ET with gestational transient hyperthyroidism

A case of triplet pregnancy with IVF-ET with gestational transient hyperthyroidism

Chorionicity inaccurately predicted by early ultrasound: a case report

Ultrasound has been found to be extremely accurate in diagnosing the chorionicity of multiple gestations. Prenatal counselling and/or planning for selective termination is most often based on the sonographic prediction of chorionicity. We present a case of triplet pregnancy in which early sonographic prediction of chorionicity did not match the pathological diagnosis at delivery.

Consecutive triplet pregnancies following in-vitro fertilization and embryo transfer. Two case reports

The number of multiple pregnancies has been increasing as a result of the relatively widespread use of drugs for induction of ovulation and assisted conception techniques. This paper details the first reported cases of triplet pregnancies occurring in consecutive IVF cycles in two patients.

Circulating maternal serum progesterone in high-risk pregnancies

Serum progesterone was measured by competitive protein-binding assay in 331 cases of normal pregnancy ranging from 6 to 42 weeks. Serial estimations of serum progesterone were performed in nine cases of severe hypertensive disorder of pregnancy, eight cases of twin pregnancy, three cases of twin pregnancy complicated by severe hypertensive disorder of pregnancy, three cases of triplet pregnancy, three cases of previous bad obstetric history, one case of anencephaly, and seven cases of intrauterine fetal death. Serum progesterone remained within normal range in severe hypertensive disorder of pregnancy and the levels were indistinguishable in cases of fetal growth retardation from those without growth retardation. In twin and triplet pregnancies, serum progesterone was within normal range or elevated and was usually higher than normal in twin pregnancies after weeks 33 to 34. Serum progesterone levels were normal in anencephalic pregnancy and in most cases of intrauterine fetal death. The findings are discussed with reference to placental hormonal activity. It is concluded that serum progesterone is a poor index of placental function.

Estrogen monitoring and the prevention of ovarian overstimulation during gonadotropin therapy

The results of therapy with human menopausal gonadotropin (HMG) was compared in patients controlled by the development of fern formation with patients monitored by daily total estrogen excretion. The percentage of anovulatory cycles and pregnancies were high with both methods. There were less multiple pregnancies and cases of ovarian enlargement when estrogen monitoring was utilized. Of most significance was the fact that there were no cases of triplet pregnancy or cases of massive ovarian enlargement with or without ascites when estrogen monitoring was utilized.