Delivery of uncomplicated triplet pregnancies: is the vaginal route safer?
Article Abstract:
Vaginal birth of triplets may produce better outcomes than cesarean delivery in selected cases. Vaginal birth was attempted in 23 of a series of 69 triplet pregnancies. Criteria were uncomplicated pregnancy, normal pelvis, head-down presentation of the first triplet, no uterine scar, and labor onset at or beyond 32 weeks gestation. Four cesareans were performed, two for lack of progress and two for fetal distress. Outcomes were matched for gestational age with 23 triplet births from uncomplicated pregnancies delivered by planned cesarean. One triplet delivered by cesarean section for lack of progress in the attempted vaginal birth group died on day 2. The 5-minute Apgar score was 8 so labor did not appear to contribute to cause of death. Apgar scores averaged 9.5 in the attempted vaginal birth group versus 8.4 in the planned cesarean group, and stay in the neonatal intensive care nursery averaged 6 days in the attempted vaginal birth group versus 18 days in the planned cesarean group.
Publication Name: American Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0002-9378
Year: 1995
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Magnetic resonance imaging of defects in DeLancey's vaginal support levels I, II, and III
Article Abstract:
Magnetic resonance imaging (MRI) scans may be performed before surgery to identify vaginal defects, and after surgery to verify that defects were corrected. Defects in vaginal support may cause urinary stress incontinence. Researchers performed MRI scans before and after surgery of 12 patients who had urinary stress incontinence and hernias of the bladder and urethra. Three different types of defects were identified in three different areas of the vagina, known as DeLancey's level I, II, and III vaginal support. MRI scans enabled surgeons to anticipate the specific defect and to check their work after surgery. Defects were corrected after one operation in 10 of the 12 patients, and none of these patients experienced urinary stress incontinence following surgery.
Publication Name: American Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0002-9378
Year: 1995
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