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The maternal and neonatal outcome in quadruplet and quintuplet versus triplet gestations

Objective: Examination and comparation of the natural history of triplet versus quadruplet and quintuplet gestations. Study design: A retrospective study of 64 multifetal pregnancies (52 sets of triplets, 9 sets of quadruplets and 3 sets of quintuplets) cared for during past 12 years in our department. Quintuplets and quadruplets were compared with triplet pregnancies according to gestational age, birthweight, pregnancy complications and perinatal outcome. Student’s t-test, Fisher exact test and chi-square test were used for statistical analysis, considering p value of <0.05 as statistically significant. Results: Although mean gestational age at delivery between triplets and higher order gestations was not significantly different, birthweight of quadruplets and quintuplets was significantly lower. Pregnancy complications, including intrauterine growth retardation, were equally distributed between the groups. Early neonatal and perinatal mortality were significantly higher in quadruplets and quintuplets than in triplets. Surprisingly, survival of growth retarded fetuses was better than survival of their eutrophic counterparts. The spontaneous loss rate was 11.5 % for entire triplet gestation and 16.7 % for quadru- and quintuplet pregnancies. Conclusions: As the spontaneous loss rate of triplets and higher order pregnancies observed in our study is quite similar to pregnancy loss rate caused by multifetal pregnancy reduction, conservative management of multifetal pregnancies in specialised tertiary centers seems to be a prudent solution.

multifetal pregnancies; perinatal outcome; conservative management

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