General Principles for Counseling and Management of Triplet Pregnancies

Clin Obstet Gynecol. 2023 Dec 1;66(4):854-863. doi: 10.1097/GRF.0000000000000814. Epub 2023 Nov 13.

Abstract

Compared with singleton pregnancies, triplet pregnancies are associated with a significantly increased risk of adverse pregnancy outcomes. Early ultrasound examination is the best way to diagnose triplets, establish dating, and determine the number of placentas to provide appropriate counseling and monitoring. Dichorionic placentation adds risks specifically associated with a shared placenta, and limits options for intervention. Multifetal reduction is an option that can significantly improve pregnancy outcomes compared with non-reduced triplet pregnancies. Integration of a Maternal-Fetal Medicine specialist in the prenatal care for a triplet pregnancy reduces the risk of preeclampsia, preterm birth, low birthweight infants, perinatal mortality, and major neonatal morbidity.

MeSH terms

  • Counseling
  • Female
  • Gestational Age
  • Humans
  • Infant
  • Infant, Newborn
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy Reduction, Multifetal / adverse effects
  • Pregnancy, Triplet*
  • Premature Birth* / etiology
  • Premature Birth* / prevention & control
  • Retrospective Studies