Perinatal, postnatal, and maternal outcome parameters of triplet pregnancies according to the planned mode of delivery: results of a single tertiary center

Objective. To compare the maternal and perinatal outcome of triplet pregnancies delivered by cesarean section with those delivered vaginally and to assess whether a vaginal delivery of triplets is still acceptable among women who are interested in further births. Study design. A retrospective analysis of 73 triplet pregnancies delivered at >= 28 week between 1997 and 2005 in a single tertiary center. Twenty-six triplets planned for a trial of labor were compared with 47 sets of women with triplet gestations who delivered by scheduled cesarean section. Results. Mean gestational age was 33.1 +/- 2.9 and 33.4 +/- 2.6 weeks for the vaginal and cesarean groups, respectively (NS). 88.4% of the vaginally-intended group had a successful vaginal delivery of all three newborns. There were four cases of mortality among the triplets that underwent a vaginal trial of labor (50/1000) but none in the planned cesarean delivery group. Neonatal and maternal complication rates were not different between the groups. Conclusion. According to the relatively small number of patients included in this study, the safety of vaginal delivery should be considered uncertain. Vaginal delivery for triplets might be possible just in particular cases, >28 weeks, with future risks for further pregnancies, after thorough consult with the couple and under strict protocol.