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PubMed1999

Repeating triplets of spikes and oscillations in the mitral cell discharges of freely breathing rats.

The olfactory bulb responses to odours display evident temporal organization, both in the form of high-frequency oscillations and precisely replicating triplets of spikes. In this study, the frequency of replicating triplets in a sample of 118 individual responses from 45 cells was compared with that in simulations of non-homogeneous Poisson processes, constructed from the experimental post-stimulus time histograms (PSTHs). In a large majority of the records, replicating triplets (to a precision of 0.5 ms) are found to be more numerous in the physiological records; in some of them, they are approximately 10 times more abundant. An excess of precisely replicating triplets is also found in records where no oscillations are apparent in the autocorrelograms. Triplet replication thus seems a more robust phenomenon than transient oscillation. Not unlike fast oscillations observed in other preparations, replicating triplets produced by a given mitral cell are generally observed only during a restricted period of time of the respiratory cycle (at least in the case of the responses under olfactory stimulation). No relation was found, however, between the nature and strength of the olfactory stimulus and the frequency of replicating patterns. In the absence of olfactory stimulation, some mitral cell discharges also contain more replicating triplets than the non-homogeneous Poisson simulations. Thus, replicating triplets in single-cell discharges seem to play only an indirect role in the coding of olfactory information at the mitral cell output level.

Anesthesia↗

PubMed1985

Effect of magnetic fields on the triplet state lifetime in photosynthetic reaction centers: Evidence for thermal repopulation of the initial radical pair.

The lifetime of the molecular triplet state formed by recombination of the radical ion pair in quinonedepleted bacterial photosynthetic reaction centers is found to depend on applied magnetic field strength. It is suggested that this magnetic field effect results from thermally activated repopulation of the same radical ion pair that generates the triplet. Consistent with this hypothesis, the magnetic field effect on the triplet lifetime disappears at low temperature where the triplet state decays exclusively by ordinary intersystem crossing. This activated pathway for the decay of the triplet state can explain the strong temperature dependence of the triplet decay rate. A detailed theoretical treatment of the problem within a set of physically reasonable assumptions relates the observed temperature dependence of the triplet decay rate to the energy gap between the radical ion pair intermediate and the triplet state. This energy gap is estimated to be about 950 cm(-1) (0.12 eV). Combined with an estimate of the energy of the donor excited state, we obtain an energy gap between the excited singlet state of the donor and the radical ion pair of 2,250 cm(-1) (0.28 eV).

Journal Article↗

PubMed2003

Triplet repeats in human genome: distribution and their association with genes and other genomic regions.

MOTIVATION: Simple sequence repeats (SSRs) or microsatellite repeats are found abundantly in many prokaryotic and eukaryotic genomes. Among SSRs, triplet repeats are of special significance because some of them have been linked to various genetic disorders. The objective of the study is to analyze the triplet repeats of complete human genome and to identify the genes that contain the triplet repeats in their coding region. The analysis will help us to identify the candidate genes that have potential for repeat expansion. RESULTS: We have analyzed triplet repeats in the complete human genome from the publicly available sequences. Our analysis revealed that AGC and CCG repeat were predominantly present in the coding regions of the genome while UTRs and the upstream sequences contained CCG repeats in relative abundance. Analysis of density of triplet repeats (bp/Mb) revealed that AAT and AAC were the abundant repeats whereas ACT and ACG were the rare repeats found in human genome. We could identify about 2135 known or predicted genes that were associated with at least one of the triplet repeat types. A large proportion of putative transcripts that were identified by gene finding programs were found to be associated with triplet repeats. These transcripts will be the candidate genes for analysis of triplet repeat expansion and a possible association with disease phenotypes. Identification of 171 genes which contain a minimum of ten repeat units will be of particular interest in future in correlating their association with any disease phenotype due to the expansion potential of repeats present in them. The list of genes and other details of analysis are given in the online supplementary data (http://www.ingenovis.com/tripletrepeats).

Databases, Nucleic Acid↗

PubMed1999

Somatic sequence variation at the Friedreich ataxia locus includes complete contraction of the expanded GAA triplet repeat, significant length variation in serially passaged lymphoblasts and enhanced mutagenesis in the flanking sequence.

The vast majority of Friedreich ataxia patients are homozygous for large GAA triplet repeat expansions in intron 1 of the X25 gene. Instability of the expanded GAA repeat was examined in 23 chromosomes bearing 97-1250 triplets in lymphoblastoid cell lines passaged 20-39 times. Southern analyses revealed 18 events of significant changes in length ranging from 69 to 633 triplets, wherein the de novo allele gradually replaced the original over 1-6 passages. Contractions and expansions occurred with equal frequency and magnitude. This behavior is unique in comparison with other large, non-coding triplet repeat expansions [(CGG)(n)and (CTG)(n)] which remain relatively stable under similar conditions. We also report a rare patient who, having inherited two expanded alleles, showed evidence of contracted GAA repeats ranging from nine to 29 triplets in DNA from two independent peripheral blood samples. The GAA triplet repeat is known to adopt a triplex structure, and triplexes in transcribed templates cause enhanced mutagenesis. The poly(A) tract and a 135 bp sequence, both situated immediately upstream of the GAA triplet repeat, were therefore examined for somatic mutations. The poly(A) tract showed enhanced instability when in cis with the GAA expansion. The 135 bp upstream sequence was found to harbor a 3-fold excess of point mutations in DNA derived from individuals homozygous for the GAA triplet repeat expansion compared with normal controls. These data are likely to have important mechanistic and clinical implications.

Base Sequence↗

PubMed1995

Hairpin properties of single-stranded DNA containing a GC-rich triplet repeat: (CTG)15.

Although triplet repeat DNA sequences are scattered throughout the human genome, their biological function remains obscure. To aid in correlating potential structures of these nucleic acids with their function, we propose their classification based on the presence or absence of a palindromic dinucleotide within the triplet, the G + C content, and the presence or absence of a homopolymer. Five classes of double-stranded (ds) triplet repeats are distinguished. Class I repeats, which are defined by the presence of a GC or CG palindrome, have the lowest base stacking energies, exhibit the lowest rates of slippage synthesis [Schlötterer and Tautz (1992) Nucleic Acids Res., 20, 211] and are uniquely associated with triplet repeat expansion diseases. The six single-stranded (ss) triplet repeats within Class I also have the potential to form hairpin structures, as determined by energy minimization. To explore the possibility of hairpin formation by ss Class I triplet repeats, studies were performed with a ss oligonucleotide containing 15 prototypic CTG repeats [ss (CTG)15]. Electrophoretic, P1 nuclease and KMnO4 oxidation data demonstrate that ss (CTG)15 forms a hairpin containing base paired and/or stacked thymines in the stem. Potential functions of hairpins containing Class I triplet repeats are discussed with respect to protein translation and mRNA splicing. Further, potential roles of hairpin structures in triplet repeat expansion events are discussed.

Base Composition↗

PubMed2004

Differences in mortality predictions between Injury Severity Score triplets: a significant flaw.

BACKGROUND: This study investigated the validity of similar Injury Severity Scores (ISS) generated by different Abbreviated Injury Scale triplets. METHODS: A cohort of trauma patients admitted to a single major trauma service between 1995 and 2002 was studied retrospectively. Mortality rates were compared for groups with identical ISS scores but different triplets. RESULTS: For 2,223 of the 5,946 trauma patients studied, 12 ISS scores were generated by two different Abbreviated Injury Scale triplets. Six of these ISS totals showed significant differences in mortality depending on the triplet source. One of the most striking was ISS 25 (triplet 5,0,0), with a mortality of 20.6%, as compared with 0% for triplet 4,3,0 (p = 0.005). The other statistically significant mortality differences for ISS totals were ISS 27-28.6% (5,1,1) versus 7.4% (3,3,3) (p = 0.05); ISS 29-30.3% (5,2,0) versus 4.6% (4,3,2) (p = 0.002); ISS 33-50% (4,4,1) versus 6.7% (5,2,2) (p = 0.034); ISS 34-45.2% (5,3,0) versus 4.3% (4,3,3) (p = 0.0009); and ISS 41-60% (5,4,0) versus 11.1% (4,4,3) (p = 0.05). CONCLUSIONS: The mortality rates are significantly different between pairs of triplets that generate the same ISS total. Caution must be used in the interpretation of outcomes from ISS values generated by different triplets.

Abbreviated Injury Scale↗

PubMed1997

Triplet energy transfer between the primary donor and carotenoids in Rhodobacter sphaeroides R-26.1 reaction centers incorporated with spheroidene analogs having different extents of pi-electron conjugation.

Three carotenoids, spheroidene, 3,4-dihydrospheroidene and 3,4,5,6-tetrahydrospheroidene, having 8, 9 and 10 conjugated carbon-carbon double bonds, respectively, were incorporated into Rhodobacter (Rb.) sphaeroides R-26.1 reaction centers. The extents of binding were found to be 95 +/- 5% for spheroidene, 65 +/- 5% for 3,4-dihydrospheroidene and 60 +/- 10% for 3,4,5,6-tetrahydrospheroidene. The dynamics of the triplet states of the primary donor and carotenoid were measured at room temperature by flash absorption spectroscopy. The carotenoid, spheroidene, was observed to quench the primary donor triplet state. The triplet state of spheroidene that was formed subsequently decayed to the ground state with a lifetime of 7.0 +/- 0.5 microseconds. The primary donor triplet lifetime in the Rb. sphaeroides R-26.1 reaction centers lacking carotenoids was 60 +/- 5 microseconds. Quenching of the primary donor triplet state by the carotenoid was not observed in the Rb. sphaeroides R-26.1 reaction centers containing 3,4-dihydrospheroidene nor in the R-26.1 reaction centers containing 3,4,5,6-tetrahydrospheroidene. Triplet-state electron paramagnetic resonance was also carried out on the samples. The experiments revealed carotenoid triple-state signals in the Rb. sphaeroides R-26.1 reaction centers incorporated with spheroidene, indicating that the primary donor triplet is quenched by the carotenoid. No carotenoid signals were observed from Rb. sphaeroides R-26.1 reaction centers incorporating 3,4-dihydrospheroidene nor in reaction centers incorporating 3,4,5,6-tetrahydrospheroidene. Circular dichroism, steady-state absorbance band shifts accompanying the primary photochemistry in the reaction center and singlet energy transfer from the carotenoid to the primary donor confirm that the carotenoids are bound in the reaction centers and interacting with the primary donor. These studies provide a systematic approach to exploring the effects of carotenoid structure and excited-state energy on triplet transfer between the primary donor and carotenoids in reaction centers from photosynthetic bacteria.

Carotenoids↗

PubMed2003

Inter- and intraspecific variation in excited-state triplet energy transfer rates in reaction centers of photosynthetic bacteria.

In protein-cofactor reaction center (RC) complexes of purple photosynthetic bacteria, the major role of the bound carotenoid (C) is to quench the triplet state formed on the primary electron donor (P) before its sensitization of the excited singlet state of molecular oxygen from its ground triplet state. This triplet energy is transferred from P to C via the bacteriochlorophyll monomer B(B). Using time-resolved electron paramagnetic resonance (TREPR), we have examined the temperature dependence of the rates of this triplet energy transfer reaction in the RC of three wild-type species of purple nonsulfur bacteria. Species-specific differences in the rate of transfer were observed. Wild-type Rhodobacter capsulatus RCs were less efficient at the triplet transfer reaction than Rhodobacter sphaeroides RCs, but were more efficient than Rhodospirillum rubrum RCs. In addition, RCs from three mutant strains of R. capsulatus carrying substitutions of amino acids near P and B(B) were examined. Two of the mutant RCs showed decreased triplet transfer rates compared with wild-type RCs, whereas one of the mutant RCs demonstrated a slight increase in triplet transfer rate at low temperatures. The results show that site-specific changes within the RC of R. capsulatus can mimic interspecies differences in the rates of triplet energy transfer. This application of TREPR was instrumental in defining critical energetic and coupling factors that dictate the efficiency of this photoprotective process.

Electron Spin Resonance Spectroscopy↗

PubMedDate not supplied

Impact of gestational age at delivery of the economics of triplet pregnancy.

OBJECTIVE: To establish the charges associated with triplet pregnancies managed at a single tertiary center, over a 5-year time period, and to evaluate the impact of prematurity on these charges. METHODS: All triplet pregnancies that reached at least 20 weeks gestation and received prenatal and neonatal care at our center from 1992 to 1996 were included. Charges for these mothers and neonates were extracted from two separate hospital billing computer systems, encompassing all inpatient, outpatient, technical, and professional charges. Linear regression was used to evaluate the relationship between gestational age at delivery and total charges. RESULTS: Fifty-five triplet pregnancies were included, resulting in the admission of 149 liveborn neonates. The median gestational age at delivery was 32.1 weeks. The mean charges per triplet mother were: $6,899 (professional), $3,959 (hospital outpatient), and $32,686 (hospital inpatient). The mean charges per neonatal sibling set were: $20,107 (professional) and $124,163 (hospital inpatient). The mean charges per complete triplet pregnancy was $187,814 (maternal plus neonatal). There was a significant inverse relationship between gestational age at delivery and total charges per triplet family, with a decrease of $16,584 for each additional gestational week reached (P = 0.006). CONCLUSIONS: Triplet pregnancy charges averaged almost $190,000 each, which does not include charges associated with assisted reproductive technologies. These charges are almost all related to the expense of prolonged neonatal intensive care, and are significantly related to the gestational age at delivery. Efforts at containing these costs should focus on reducing the incidence of multiple gestation and preventing prematurity.

Boston↗

PubMed1993

Evaluation of triplet growth status at birth using individualized growth assessment: comparison with conventional methods and development of a new classification system.

A new growth classification system for triplets based on individual growth curve standards provides new information on the growth status of triplets at birth. OBJECTIVES. The objectives of this study were to characterize growth outcome at birth in triplet pregnancies using Individualized Growth Assessment methods, and to compare these results to conventional methods of growth outcome evaluation. STUDY DESIGN. Rossavik growth models derived from second-trimester ultrasound measurements were used to predict the birth characteristics of 21 triplet neonates. Actual measurements of weight, head, abdominal, and thigh circumferences at birth were compared to population standards and to predicted values, the latter by calculation of Growth Potential Realization Index (GPRI) values. GPRI values were calculated using singleton (measurement procedure correction) and triplet (measurement procedure correction+decreased soft tissue deposition) correction factors (SCF, TCF). Neonatal Growth Assessment Scores (NGAS) were calculated using both sets of GPRI values. RESULTS. Three types of triplet neonates were identified. Group I (33.3%) were normal with both types of NGAS values, had very few abnormal GPRI values or anatomic measurements, and were all appropriate for gestational age. Group III (14.3%) were abnormal with both types of NGAS values, most GPRI values were abnormal, and all were small for gestational age. Group II (52.4%) had abnormal NGAS values when calculated from GPRI values determined with SCF and normal NGAS values when calculated from GPRI values determined with TCF. All but one was AGA. Almost all GPRIWT and GPRIThC values were abnormal using SCF and normal using TCF. CONCLUSION. Although growth outcome in triplet neonates can be normal (Group I) or intrauterine growth retarded (Group III), the majority are in an intermediate group (Group II) characterized by a decrease in soft tissue mass, which may or may not be pathological.

Adult↗

PubMed1991

Cross-sectional analysis of triplet birth weight.

Parameters of fetal growth in triplet gestations are poorly studied and controversial. A cross-sectional analysis of triplet birth weight was performed to elucidate fetal growth patterns. Birth weight and gestational age data were analyzed on 580 infants in 196 triplet sets (eight stillborn infants excluded) between 1985 and 1988. Ovulation induction was used in approximately one half the gestations and early obstetric and ultrasonographic dating was available in all pregnancies. The mean triplet set and individual triplet weights versus gestational age were calculated with distinctly linear growth displayed between 22 to 38 weeks' gestation. Mean intratriplet differences at all gestational ages were determined. A comparison of singleton and triplet growth curves was constructed to show the distinct growth characteristics of triplets.

Birth Weight↗

PubMed1993

Epidemiological and birth weight characteristics of triplets: a study from the Dutch twin register.

From 112 triplet sets, born in The Netherlands from the end of 1986 to the beginning of 1991 and registered in the Dutch Twin Register, several details such as birth weight, gestational age, zygosity, and etiology were assessed by questionnaire, which was filled out by the mother. For 33 triplet sets, zygosity was also assessed by blood typing. Maternal smoking during pregnancy was also noted. Results show a very strong increase in number of triplets caused by artificial fertility enhancing techniques and consequently a shift in the relative contribution of zygosity types to the total number of triplets. Birth weight is predominantly influenced by gestational age. Other effects on birth weight are controlled for possible confounding with gestational age. First born triplets weigh more than later born triplets; boys weigh more than girls; nearly 25% of all individual triplets weigh less than 1500 g, i.e. belong to the category very low birth weight (VLBW); regular maternal smoking produces a 14% birth weight reduction; ovulation induction seems to decrease the sex ratio, i.e. hormonal treatment with ovulation inducing substances increases the probability of female offspring.

Adult↗

PubMed2004

Early mortality among triplets in the United States: black-white disparity.

OBJECTIVE: In this study, we sought to estimate the black-white gap in early mortality among triplets. STUDY DESIGN: This was a retrospective cohort study on triplets delivered in the United States from 1995 to 1997. We computed relative risks for early mortality among triplets born to black mothers using the generalized estimating equation framework. RESULTS: There were 1317 black and 14,364 white triplets analyzed. Black triplets were twice as likely to have neonatal and infant mortality compared with whites (Odds ratio [OR], 2.00, 95% CI, 1.38-2.77; and OR, 2.20, 95% CI, 1.59-3.00, respectively). The widest disparity was observed postneonatally, with black triplets sustaining a level of risk almost 4-fold that of whites (OR, 3.60, 95% CI, 2.10-6.10). Stillbirth and perinatal mortality were comparable for both races. CONCLUSION: Black-white disparity for early mortality among triplets was widest postneonatally. This finding bears important clinical and public health implications.

Adult↗

PubMed2005

Mode of delivery and risk of stillbirth and infant mortality in triplet gestations: United States, 1995 through 1998.

OBJECTIVE: The purpose of this study was to estimate the risks of stillbirth and neonatal and infant deaths in triplets, according to mode of delivery. STUDY DESIGN: We used the "matched multiple birth" data file that was comprised of triple births that were delivered in the United States in the years 1995 through 1998. Analyses were restricted to fetuses that were delivered at >/=24 weeks of gestation. Based on the order of the birth of the fetuses within the triplet set, the mode of delivery of triplets was assigned as cesarean-cesarean-cesarean (all cesarean), vaginal-vaginal-vaginal (all vaginal), and vaginal-cesarean-cesarean or vaginal-vaginal-cesarean (other). Associations between mode of delivery and stillbirth, neonatal deaths (within 28 days), and infant deaths (up to 1 year) were expressed as relative risks with 95% confidence intervals and population attributable risks, which were derived from multivariate logistic regression models that were based on the method of generalized estimated equations (with all cesarean deliveries serving as the reference). All analyses were adjusted for several confounding factors. RESULTS: Ninety-five percent of all triplets were delivered by cesarean delivery. Vaginal delivery (all vaginal) was associated with an increased risk for stillbirth (relative risk, 5.70; 95% CI, 3.83, 8.49) and neonatal (relative risk, 2.83; 95% CI, 1.91, 4.19) and infant (relative risk, 2.29; 95% CI, 1.61, 3.25) deaths. The population-attributable risks were 15.9% for neonatal and 12.4% for infant deaths, which implied that these proportions of deaths were potentially avoidable had these triplet fetuses all been delivered by cesarean delivery rather than all fetuses being delivered vaginally. CONCLUSION: Cesarean delivery of all 3 triplet fetuses is associated with the lowest neonatal and infant mortality rate. Vaginal delivery among triplet gestations should be avoided.

Cesarean Section↗

PubMed2004

How and why are triplets disadvantaged compared to twins?

The current epidemic of triplets, a result of the widespread use of assisted reproduction, started less than two decades ago. Its full impact has been appreciated only recently. Triplets are disadvantaged from every perinatal perspective compared to twins--preterm birth, low birth weight, morbidity and mortality--because the human uterus probably is better equipped to carry twins than triplets. Although modern neonatal care has improved survival rates of preterm as well as low-birth-weight triplets, other complications remain and are of great clinical importance. The alternative to carrying triplets--multifetal pregnancy reduction--is associated with improved outcomes, as expected from comparing twin to higher-order multiples. However, the improved outcomes of triplets in recent years might call for second thoughts about the frequent recommendation of multifetal pregnancy reduction of triplets to twins.

Abortion, Spontaneous↗

PubMed1994

A prospective comparison of the outcome of triplet pregnancies managed expectantly or by multifetal reduction to twins.

OBJECTIVE: Our aim was to compare the outcome of triplet pregnancies managed expectantly or by multifetal reduction to twins. STUDY DESIGN: From January 1984 through January 1992, 140 triplet gestations were diagnosed before the ninth gestational week. Multifetal pregnancy reduction was performed at the patient's request in 34 women. The remaining 106 triplet pregnancies were managed expectantly. All patients were prospectively followed up and delivered in a single perinatal department. RESULTS: Loss of the entire pregnancy before 25 gestational weeks occurred in 20.7% of the triplet pregnancies managed expectantly as compared with 8.7% in the group with reduction to twins. A successful pregnancy as defined by the discharge home of at least one infant occurred in 88.2% of the group with reduction to twins and 74.5% of the triplets managed expectantly. Fetal reduction to twins was associated with a significantly lower incidence of the following: prematurity (p < 0.001), low-birth-weight infants (p < 0.001), and very-low-birth-weight infants (p < 0.001). Pregnancy complications and neonatal morbidity and mortality were less in the group with reduction to twins. CONCLUSIONS: Multifetal pregnancy reduction of triplet pregnancies to twins resulted in improved pregnancy outcome without an excess loss of the entire pregnancy as compared with the outcome of triplet gestations managed expectantly.

Abortion, Therapeutic↗

PubMed1999

Ultrasonographic assessment of cervical length in triplet pregnancies.

OBJECTIVE: Our goal was to evaluate the utility of ultrasonographic assessment of cervical length in the management of triplet pregnancies and to compare these measurements with previously reported data for singleton pregnancies. STUDY DESIGN: The maternal records for all triplet pregnancies managed at the Mayo Medical Center from January 1993-January 1998 were reviewed. Cervical length assessment was undertaken at regular intervals during each pregnancy according to an established real-time transperineal ultrasonographic technique. Presence or absence of cervical funneling was noted at the time of the examination. Obstetric management and outcome data were assessed. RESULTS: Thirty-two triplet pregnancies were managed at our institution between January 1993 and January 1998. Average duration of pregnancy (+/-SD) was 32.4 +/- 2.3 weeks. Progressive cervical shortening was noted with advancing gestational age; average cervical lengths (+/-SD) were 42.0 +/- 5.0 mm at 10 weeks, 37.0 +/- 8.0 mm at 20 weeks, 26.0 +/- 10.0 mm at 25 weeks, and 21.0 +/- 7.0 mm at 30 weeks. Comparison of triplet cervical length measurements with reported data from singleton pregnancies revealed a significant difference between the singleton and triplet data, respectively, at both 24 weeks (35.2 +/- 8.3 mm vs 25.0 +/- 8.0 mm, P <.001) and 28 weeks (33.7 +/- 8.5 mm vs 28.0 +/- 11.0 mm, P <.005). Cervical funneling was noted in 3 women with an average of 27 days from onset to delivery. CONCLUSIONS: Ultrasonographic assessment of cervical length is a useful adjuvant in the management of the triplet gestation. Triplet cervical length measurements are significantly different from those reported for gestational age-matched singleton pregnancies. Premature cervical shortening and the presence of cervical funneling are harbingers of premature delivery and should necessitate obstetric intervention.

Cervix Uteri↗

PubMed1998

Management and outcome of triplet pregnancy.

The parameters involved in obstetrical follow-up of triplet pregnancies were evaluated in a retrospective study between 1975-1993 of the follow-up of 91 triplet pregnancies. During this long interval of time, many changes in management of triplets occurred. Considering these differences, two periods in the present study were compared: 1975-1986, which consists of a previously published retrospective analysis of 21 triplet pregnancies; and 1987-1993, during which the modalities of the 7-year follow-up described previously were applied to 70 triplet pregnancies. No improvement was observed between the two periods. Nineteen pregnancies were spontaneous. Thirty-seven allowed treatment with ovulation induction agents and 35 were due to in vitro Fertilization. Early diagnosis of multiple pregnancies allows installation measures for the prevention of prematurity. Management, initiated upon diagnosis, included home rest and a weekly follow-up at home by a midwife every week. Monthly consultations and ultrasounds were performed at the hospital. Hospitalization was not systematic but was done in cases of maternal complications. The mean term for the diagnosis of triplet pregnancy was 13.9 +/- 5.3 weeks. The mean gestational age was 33.4 weeks; 90% of the deliveries were by cesarean section. The mean weight of the neonates was 1716 g. The mean Apgar score at 1 and 5 m was 7.7 and 9.3, respectively. The perinatal mortality was 80 per 1000. The main neonatal complications resulted from prematurity. Authors compared rates of Hyaline Membrane Disease in infants of patients treated with corticosteroids and of patients who were not. Hyaline Membrane Disease occurred in 13% of the corticotherapy group and in 31% of the untreated group. The present study supports systematic corticotherapy between 28 and 34 weeks for triplet pregnancies.

Adult↗