PLANNED ABDOMINAL COMPARED WITH PLANNED VAGINAL BIRTH IN TRIPLET PREGNANCIES

Objective To compare a policy of planned abdominal delivery with a pol icy of planned vaginal delivery in triplet pregnancies. Design Retrosp ective study. Setting Two Dutch university hospitals, each having a di fferent approach to the planned mode of delivery in triplet gestations . Subjects Thirty women giving birth to triplets in the hospital in Le iden, who favoured planned abdominal delivery, compared with 39 from t he Medical Centre in Amsterdam who favoured vaginal delivery. Main out come measures Perinatal mortality and early neonatal complications. Re sults Both centres were equally successful in achieving their planned policies: in Leiden 80% of women were delivered by caesarean section b ut in Amsterdam 87% of women were delivered vaginally. Compared with v aginal delivery, planned abdominal delivery was associated with a sign ificantly higher perinatal mortality rate (P = 0.02), primarily due to respiratory distress syndrome, and a higher recorded neonatal complic ation rate (P = 0.03), especially sepsis, respiratory distress syndrom e, and necrotising enterocolitis. Conclusions A policy of planned abdo minal delivery in triplets is not superior to a policy of planned vagi nal delivery in terms of fetal and early neonatal outcome.