How and why are triplets disadvantaged compared to twins?

被引:22
作者
Blickstein, I [1 ]
机构
[1] Kaplan Med Ctr, Dept Obstet & Gynecol, Working Grp Multiple Pregnancy, IL-76100 Rehovot, Israel
[2] Hadassah Hebrew Univ, Sch Med, Jerusalem, Israel
关键词
twins; triplets; multiple pregnancy; pregnancy complications; neonatal mortality; neonatal morbidity;
D O I
10.1016/j.bpobgyn.2004.04.014
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
The current epidemic of triplets, a result of the widespread use of assisted reproduction, started less than two decades ago. Its full impact has been appreciated only recently. Triplets are disadvantaged from every perinatal perspective compared to twins-preterm birth, low birth weight, morbidity and mortality-because the human uterus probably is better equipped to carry twins than triplets. Although modern neonatal care has improved survival rates of preterm as well as low-birth-weight triplets, other complications remain and are of great clinical importance. The alternative to carrying triplets-multifetal pregnancy reduction-is associated with improved outcomes, as expected from comparing twin to higher-order multiples. However, the improved outcomes of triplets in recent years might call for second thoughts about the frequent recommendation of multifetal pregnancy reduction of triplets to twins.
引用
收藏
页码:631 / 644
页数:14
相关论文
共 55 条
[1]   What are the fetal growth patterns of singletons, twins, and triplets in the United States? [J].
Alexander, GR ;
Kogan, M ;
Martin, J ;
Papiernik, E .
CLINICAL OBSTETRICS AND GYNECOLOGY, 1998, 41 (01) :115-125
[2]   Aggressive perinatal care for high-order multiple gestations: Does good perinatal outcome justify aggressive assisted reproductive techniques? [J].
Angel, JL ;
Kalter, CS ;
Morales, WJ ;
Rasmussen, C ;
Caron, L .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1999, 181 (02) :253-258
[3]   Neonatal outcome of triplet versus twin and singleton pregnancies: a matched case control study [J].
Ballabh, P ;
Kumari, J ;
AlKouatly, HB ;
Yih, M ;
Arevalo, R ;
Rosenwaks, Z ;
Krauss, AN .
EUROPEAN JOURNAL OF OBSTETRICS GYNECOLOGY AND REPRODUCTIVE BIOLOGY, 2003, 107 (01) :28-36
[4]   Risk for one or two very low birth weight twins: A population study [J].
Blickstein, I ;
Goldman, D ;
Mazkereth, R .
OBSTETRICS AND GYNECOLOGY, 2000, 96 (03) :400-402
[5]  
Blickstein I, 2003, CONTROVERSIES IN PERINATAL MEDICINE, P161
[6]   The likelihood of adverse outcomes in triplet pregnancies estimated by pregravid maternal characteristics [J].
Blickstein, I ;
Rhea, DJ ;
Keith, LG .
FERTILITY AND STERILITY, 2004, 81 (04) :1079-1082
[7]   Zygotic-splitting rates after single-embryo transfers in in vitro fertilization [J].
Blickstein, I ;
Jones, C ;
Keith, LG .
NEW ENGLAND JOURNAL OF MEDICINE, 2003, 348 (23) :2366-2367
[8]  
Blickstein I, 2003, FERTIL STERIL, V79, P661, DOI 10.1016/S0015-0282(02)04751-9
[9]   Outcome of triplets and high-order multiple pregnancies [J].
Blickstein, I ;
Keith, LG .
CURRENT OPINION IN OBSTETRICS & GYNECOLOGY, 2003, 15 (02) :113-117
[10]  
Blickstein I, 2002, DEV MED CHILD NEUROL, V44, P352