Triplet gestation: current scenario in a teaching hospital of Eastern India

Abstract

Objective: The purpose of this study was to assess obstetrical and perinatal outcomes of triplet gestations, and to explore its clinical, social, psychological, and economic impact on the parents, and their families in the context of developing countries. Methods: The records of 7 triplet pregnancies delivered in S.S.K.M. Hospital, Kolkata between 1999 and 2006, were analyzed regarding method of diagnosis, antenatal complications, mode of delivery and perinatal outcomes. A qualitative observational study was also performed in 2 cases to explore possible social, financial and psychological impact of triplet pregnancies in a low-resource setting, and to assess the parents ability to cope with these challenges. Results: The incidence of triplet gestation was 1 in 1778 deliveries in this hospital. Anemia, gestational hypertension and preterm labour were common complications. Majority (70%) of these women were delivered by caesarean section. High perinatal mortality (222 per 1000 total births) was mainly due to combination of prematurity, low birth-weight and perinatal asphyxia. The qualitative study has revealed, profound psychological impact on the mothers, especially when all 3 children from a triplet gestation were girls. Conclusions: Early diagnosis with determination of chorionicity, antenatal counseling, psychological and financial support, and availability of advanced neonatal care are the cornerstones of favorable outcome in triplet gestation. Psycho-social preparation of the parents and their families is also vital to cope with the simultaneous needs of 3 low birth-weight neonates.