The improving outcome of triplet pregnancies

Article Abstract:

A triplet pregnancy is associated with a high risk of maternal and fetal complications. In some cases, selective termination of one or more fetuses may offer an improved pregnancy outcome. However, this procedure is not without risk. To determine the risks involved, the management and outcome of 78 triplet pregnancies proceeding beyond 20 weeks of gestation, were studied. Ovulation was induced with fertility drugs in 69 (88 percent) of the pregnancies. The most commonly reported complication was premature contractions. Cervical cerclage, the process by which the cervix is secured closed artificially, did not improve the duration of pregnancy or prevent fetal loss. Most infants were born prematurely (86 percent) at an average of 33.2 weeks gestation. Fetal death occurred during delivery in 93 out of 1,000 pregnancies and death during the newborn period in 51 out of 1,000. The infants born by vaginal delivery had more respiratory problems and lower Apgar scores, a measurement of fetal well-being at one and five minutes after birth. Four infants born of low birth weights had neurological deficits. Infants born by cesarean section had better pregnancy outcomes. Fetal outcome of triplet pregnancies compares well with that of twin pregnancies. The use of selective termination in triplet pregnancies is not recommended due to the favorable triplet pregnancy outcome found in this study.

Risk factors, Triplets, Multiple birth

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A life-threatening sexually transmitted Haemophilus influenzae in septic abortion: a case report

Article Abstract:

Haemophilus influenzae is a type of bacteria that causes acute respiratory infections and conjunctivitis, an acute inflammation of the mucous membrane of the eye. It mainly infects children and is rarely seen in adults. When adults are infected, pneumonia and bronchitis are the typical manifestations, but genitourinary tract infections have been reported in septic abortion (in which the products of conception become infected). The case is reported of a patient who developed a life-threatening infection with H. influenzae in the uterus. A 28-year-old pregnant woman entered the hospital with high fever and vaginal bleeding. Antibiotic therapy was begun and an abortion was performed by means of curettage (scraping of the wall of the uterus). A few hours later she went into shock and her blood pressure dropped sharply. Blood coagulation in vessels was noted throughout the body. She was given dopamine and blood product transfusions. H. influenzae was isolated from blood cultures and she was treated accordingly. The patient appeared to have been infected by way of mouth-to-genital sexual contact 72 hours prior to onset of symptoms. These results indicate that H. influenzae infection associated with septic abortion can result in severe disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Causes of, Oral sex, Hemophilus infections, Abortion, Hemophilus influenzae, Haemophilus influenzae

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New birth weight nomograms for twin gestation on the basis of accurate gestational age

Article Abstract:

Observed growth curves of twins, based on birth weights at known gestational ages, may be useful for the clinical management of twin pregnancies in addition to expected growth curves for singleton pregnancies. The birth weights of 520 pairs of twins delivered at 28 to 41 weeks of gestational age were used to generate growth curve charts. When compared to singleton pregnancies, twins exhibited growth restriction throughout the third trimester, most pronounced in the last 4 to 6 weeks of pregnancy. Male twins were heavier on the average, compared to females.

Forecasts and trends, Fetus, Fetal growth retardation, Birth weight, Twins

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