NEONATAL OUTCOMES IN TRIPLET GESTATIONS AFTER A TRIAL OF LABOR

OBJECTIVE: This study aimed to compare neonatal outcomes in a cohort o f triplet gestations undergoing a trial of labor with those of a simil ar cohort delivered by elective cesarean delivery. STUDY DESIGN: Thirt y-three women with triplet gestations who underwent a trial of labor w ere compared with a matched cohort of 33 women with triplet gestations who were delivered of their infants by elective cesarean delivery. Ne onatal outcomes assessed included respiratory distress syndrome, retin opathy of prematurity, necrotizing enterocolitis, intraventricular hem orrhage, Apgar scores, and birth trauma. RESULTS: Twenty-nine of 33 wo men (87.9%) who underwent a trial of labor had a successful vaginal de livery of all 3 neonates. One patient was delivered of her first tripl et vaginally but then required a cesarean delivery for abruptio placen tae; 3 other patients were delivered of their infants by cesarean sect ion for active-phase arrest of labor. There were no differences in neo natal outcomes between the 2 groups, although triplet neonates deliver ed by elective cesarean section demonstrated a trend toward a greater incidence of respiratory distress syndrome (P = .09). CONCLUSION: Our experience suggests that offering vaginal delivery is an acceptable ma nagement plan for triplet gestations.