Maternal and Perinatal Outcome of Triplet Pregnancies in a Tertiary Care Hospital in North India: A Prospective Observational Study

Abstract

Background:  The purpose of this study was to identify the present trends in maternal, foetal, and perinatal outcomes and complications associated with triplet pregnancy at a tertiary referral hospital in India.

Methods: A prospective observational study was conducted over 18 months. All adult pregnant patients with ultrasound-confirmed triplet pregnancy were included. Patient demographics, measurements, and variables were recorded, with monitoring and follow-up at regular intervals. The primary endpoint of the analysis was to determine the maternal complications and perinatal outcomes associated with triplet pregnancy.

Results: Thirty-four triplet pregnancies were included in this study. The majority, 70.7% (n=31) of these women, had conceived by assisted reproductive technique (ART), mostly in vitro fertilisation (IVF), 52.9% (n=18). The most common maternal complications encountered were pre-term labour, in 82.4% (n=28) of patients. Concerning gestational age at the time of delivery, 47.1% (n=16) of patients were near-term (34-36 weeks). The majority of pregnancies, 85.3% (n=29), were terminated by lower segment caesarean section (LSCS), 8.8% (n=3) were delivered vaginally, and the mean duration of maternal hospital stay was 4.6 days ±3.45 (SD 2-14) days. Only 11.8% (n=4) required a prolonged hospital stay of > 7 days due to maternal complications. Ninety-four out of 102 triplets were born alive, with a mean birth weight of 1,597.3 grams ± (SD 367.74 g). The various foetal/neonatal complications were noted, with the commonest being prematurity in 85.3% (n=29). The majority of triplet neonates with complications had a mean duration of NICU stay less than 1 week, 70.8% (n=17).

Conclusion: While triplet pregnancies remain rare, they are associated with a significant materno-foetal risk which must be anticipated by obstetricians. Thus, early diagnosis, adequate antenatal care, counselling, and perinatal care and support can help to ensure optimal outcomes.