Triplet Pregnancies

Triplet pregnancies are challenging for everyone involved. Careful monitoring, proper care, and preparation are necessary to ensure that the multiple pregnancy is successful.

Read about triplet births.

Years ago, triplet pregnancies were extremely rare, but the numbers are on the rise. March of Dimes notes that the number of multiple births has risen significantly over the past 20 years, making the subject one of great concern. Medical interventions appear to be the reason for the increase in triplet pregnancies.

The desire to have a baby is very strong for many women and science has developed medical interventions for fertility. Two approaches in particular appear to increase the potential for multiples in a pregnancy.

• IVF: in vitro fertilization is a process in which a physician fertilizes several eggs and implants them in the woman's uterus. More than one egg is typically fertilized in order to ensure that the procedure will succeed. This often leads to more than one egg developing.

• Some Ovulation-stimulating drugs increase the chances for triplet pregnancies. Gonadtropins are particularly problematic, with roughly 30 percent resulting in multiple pregnancies.

Once a triplet pregnancy is diagnosed, it is necessary to make arrangements for prenatal care, delivery, and homecoming. This includes considering possible complications that may occur during the pregnancy.

Complications may vary according to the expectant mother's age and overall health. Physicians make special considerations for women expecting triplets during all stages of the pregnancies.

Multiple fetuses appear to develop at the same speed as a solitary fetus during the first stages. Gradually, the growth rate begins to slow for multiples. Women expecting triplets may find that the babies slow down in development at about 27 weeks gestation. This is because the babies are in competition for nutrients and room in the uterus is limited. During this time, doctors use measurements and ultrasounds to monitor development.

The demise of one of the babies in utero is very rare. If the multiples are identical, only one chorion membrane is present. Since the babies share the membrane, labor may have to be induced to ensure that all babies survive. Fraternal multiples each have their own membrane, making the pregnancy less dangerous.

Placental abruption is more likely in triplet pregnancies than in single gestations. The abruption occurs when the placenta separates from the wall of the uterus.

The pregnant mother may experience some complications as well. Two significant problems are preeclampsia and gestational diabetes. Each of these conditions may appear in single pregnancies as well.

Half of women carrying triplets develop preeclampsia, or hyptertension, during pregnancy. This high blood pressure condition is diagnosed by measuring protein levels in the urine and with blood pressure monitoring. The only way to cure the condition is to deliver the babies.

Gestational diabetes is another condition that exists exclusively during pregnancy. Women who are carrying multiples appear to have a greater risk of developing this condition. However, further testing is necessary to determine whether multiples contribute to increased risk gestational diabetes or not.

Multiple births are complicated during labor and delivery. Many women have Cesarean births, involving surgical removal of the babies. Triplet pregnancies are more likely to end in Cesarean birth.

Preterm labor occurs when labor begins before the babies reach 37 weeks gestation. Many triplet births occur at around 32 weeks gestation. Roughly 90 percent of triplet births are preterm. Preterm labor and delivery can lead to complications after the babies are born.

Postpartum problems include low birth weight since the babies are likely to be born at about 32 weeks gestation. Babies weighing fewer than 5.5 pounds are considered to have a low birth weight in normal conditions. Babies weighing fewer than 3.3 pounds are at risk for problems as newborns.

Another postpartum consideration is the increased possibility of depression in the mother. Johns Hopkins Bloomberg School of Public Health reports that women who deliver multiples are 43 percent more likely to have postpartum depression.

Bringing the babies home is a memorable moment for parents of triplets. Many do not get to experience this joyous occasion right away. In many cases, parents can expect to have at least one baby having an extended stay in the hospital. With support from professionals, family, and friends, the new additions to the family should settle in to the home within a few months.

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