[Triplet pregnancies in France. Results of a retrospective, multicenter study of two years (1987-1988). Proposals for optimal management].
The explosion of procedures for medically assisted parenthood (MAP) has resulted in a previously little known type of pregnancy: triple pregnancies. In order to assess the current obstetrical and pediatric situation, the authors have carried out a major retrospective, multicenter survey in France concerning the triple pregnancies from 1987 to 1988: 156 case histories have been collected. The finds are compared with those reported in the French and international literature, showing that in France, three-quarters of such pregnancies result from MAP, mainly due to ovulation-inducing agents. Hospitalization is prolonged (averaging 27 days), early (24 WA) and imposed by complications (in 8 out of 10 cases), prophylactic hospitalization being rarely prescribed. The main complications encountered are late miscarriages (1.9%), in-utero death (6.41%), dysgravidia (16.6%), hydramnios (5.12%) and serious cardio-pulmonary complications related to the use of beta-mimetics. A Cesarian is performed in only 87 percent of cases. The mean birth weight was 1,776 g. Neonatal mortality is on the decline, but still equivalent to 80.3 per thousand. Hypotrophy is common (27%). Birth is nearly always premature (99.3%), but very early prematurity (28-32 WA) was reduced. The approach suggested for optimum management is based on the personal experience of the authors, the findings of their survey and of the international literature. It is based on the prevention of prematurity and a fundamentally multidisciplinary approach.