Prediction of Time to Delivery Week-by-Week in Women with a Triplet Pregnancy

L. van de Mheen; A. C. Ravelli; M. A. Oudijk; S. Nij Bijvank; M. M. Porath; J. J. Duvekot; M. A. G. Holswilder-Olde Scholtenhuis; K. W. M. Bloemenkamp; H. C. J. Scheepers; M. Woiski; M. G. van Pampus; C. J. de Groot; E. Pajkrt; B. W. J. Mol

doi:10.1055/s-0036-1583190

American Journal of Perinatology, Table of Contents

Am J Perinatol 2016; 33(14): 1394-1400
DOI: 10.1055/s-0036-1583190

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Prediction of Time to Delivery Week-by-Week in Women with a Triplet Pregnancy

Authors

L. van de Mheen

¹Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, The Netherlands
A. C. Ravelli

²Department of Medical Informatics, Academic Medical Center, Amsterdam, The Netherlands
M. A. Oudijk

³Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands
S. Nij Bijvank

⁴Department of Obstetrics and Gynecology, Isala Clinics, Zwolle, The Netherlands
M. M. Porath

⁵Department of Obstetrics and Gynecology, Maxima Medical Center, Veldhoven, The Netherlands
J. J. Duvekot

⁶Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
M. A. G. Holswilder-Olde Scholtenhuis

⁷Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
K. W. M. Bloemenkamp

⁸Department of Obstetrics and Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands
H. C. J. Scheepers

⁹Department of Obstetrics and Gynecology, Maastricht University Medical Center, Maastricht, The Netherlands
M. Woiski

¹⁰Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands
M. G. van Pampus

¹¹Department of Obstetrics and Gynecology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
C. J. de Groot

¹Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, The Netherlands
E. Pajkrt

³Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands
B. W. J. Mol

¹²School of Paediatrics and Reproductive Health, The Robinson Institute, Adelaide, Australia

Abstract

Objective Some clinicians advise prophylactic administration of antenatal steroids for fetal lung maturation in women with a triplet pregnancy. However, the effect of corticosteroids is limited to 10 to 14 days after administration. The aim of this study was to assess the natural course of triplet pregnancies to allow a better anticipation for administration of corticosteroids.

Study Design We collected data on all triplet pregnancies in the Netherlands from 1999 to 2007 from the Netherlands Perinatal Registration. We calculated time to delivery, the risk of delivery in 2-week intervals at different gestational ages, and the time frame between hospital admission and delivery of the first child.

Results Median gestational age at delivery of 494 women with a triplet pregnancy was 33⁺⁴ weeks (interquartile range of 31–35⁺¹ weeks). Twenty-one women (4.3%) delivered between 22 and 24 weeks and 146 women (29.6%) delivered before 32 weeks. At a gestational age of 24 weeks, the chance to deliver within the next week was 0.6%. For 26, 28, 30, 31, and 32 weeks, these risks were 2.4, 2.5, 8.1, 7, and 16.7%, respectively.

Conclusion Before 32 weeks of gestation, prophylactic administration of steroids is not indicated as the risk to deliver within 7 days is < 10%.

Keywords

triplet pregnancy - preterm birth - antenatal steroid treatment - neonatal outcome

Full Text

References

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