Maternal neonatal outcome in quadruplet and quintuplet versus triplet gestations

Objective: Examination and comparison of the natural histories of triplet v ersus quadruplet and quintuplet gestations. Study design: A retrospective s tudy of sixty-four multifetal pregnancies (fifty-two sets of triplets, nine sets of quadruplets and three sets of quintuplets) cared for during past 1 2 years in our department. Quintuplets and quadruplets were compared with t riplet pregnancies according to gestational age, birthweight, pregnancy com plications and perinatal outcome. Student's t-test, Fisher exact test and c hi(2) test were used for statistical analysis, considering P value of <0.05 as statistically significant. Results: Although mean gestational age at de livery between triplets and higher order gestations was not significantly d ifferent, birthweight of quadruplets and quintuplets was significantly lowe r. Pregnancy complications, including intrauterine growth retardation, were equally distributed between the,groups. Early neonatal and perinatal morta lity were significantly higher in quadruplets and quintuplets than in tripl ets. Surprisingly, survival of growth retarded fetuses was better than surv ival of their eutrophic counterparts. The spontaneous loss rate was 11.5% f or entire triplet gestation and 16.7% for quadru- and quintuplet pregnancie s. Conclusions: As the spontaneous loss rate of triplets and higher order p regnancies observed in our study is quite similar to pregnancy loss rate ca used by multifetal pregnancy reduction, conservative management of multifet al pregnancies in specialised tertiary centers seems to be a prudent soluti on. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.