Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “TRIPLETS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 271 records · Page 15Linked to original sources
PubMed2001

Two cases with dichorionic diamniotic triplet pregnancy and early cord entanglement.

Within a period of 6 years (1994-99) we registered 29 triplet deliveries out of a total of 13,969 hospital deliveries (0.02%). Since there is limited information about specific problems of chorionicity in triplet pregnancies, we analysed the 29 cases according to origin of pregnancy and chorionicity. We here report on two cases with a high risk according to chorionicity with dichorionic (DC) diamniotic (DA) triplet pregnancies. Out of the two cases, one pregnancy was spontaneous and one originated after in-vitro fertilization. In both pregnancies, cord entanglement was detected early in pregnancy (at 10 and 15 weeks) by color Doppler velocimetry demonstrating different heart rates within the segment of the entangled umbilical branches. The pregnancies were followed by documenting fetal behavior and color Doppler velocimetry of umbilical and fetal arteries at weekly intervals. In both cases, a primary Cesarean section was performed after detection of lung maturity. In the first case, one of the MA triplets had a transposition of the great arteries and abnormal lung vein drainage, which was the reason for neonatal death three weeks postnatally. Although early cord entanglement has been described in MA twins, this series demonstrates that it can as well be demonstrated in MA triplets. The early detection allows for extensive surveillance of the a priori high risk triplet pregnancy.

Abnormalities, Multiple↗
PubMed2004

Trends in triplet stillbirth rates in Japan, 1975-1998.

Stillbirth rates of triplet births in the whole of Japan were analyzed using vital statistics from 1975 to 1998. Stillbirths were registered at 12 weeks gestation or later. The stillbirth rate was significantly higher in like- than in unlike-sex triplets for 1975-1998. During the 23-year period the stillbirth rate decreased from 342 to 49 per 1000 total births for like-sex and from 195 to 54 for unlike-sex triplets. The decrease in the stillbirth rate in the 23- year period was greater in both like- and unlike-sex triplets than in singleton and twin births. Risk factors for stillbirth in triplets were like-sex, youngest or oldest maternal age groups, shorter gestational age and lower birthweight. It is recommended that the optimum period to give birth for triplet pregnancies is 34-35 weeks of gestation for Japanese women.

Birth Weight↗
PubMed1992

Triplets are not so rare any more.

Triplet gestations present a considerable management challenge due to a high rate of antenatal, intrapartum and neonatal complications. The introduction of ovulation inducing agents resulted in a marked increase of these pregnancies. Consequently, triplet conceptions are not considered a rare phenomenon and have become almost routine high risk pregnancies. In our department the triplet gestation frequency increased 2-4 times in a 10 year period from a rate of 0.07-0.14% during 1978-84 to 0.28% of all deliveries in 1987. This high incidence of triplet deliveries results in a threefold increase in the frequency of triplet neonates and their associated complications. It is reasonable to assume that the wide application of various assisted reproductive techniques will result in continuous increase in the incidence of triplets which will in turn require coordinated management of a high risk pregnancy unit, delivery room and neonatal intensive care unit.

Clomiphene↗
PubMed1999

[Optimal maternal weight gain in twin and triplet pregnancy].

Our purpose was to evaluate the association between maternal weight gain patterns and pregravid body mass index (BMI), toxemia of pregnancy, birthweight, intrartum asphyxia, preterm rupture of membrane, mode of delivery and handicaps, and to make specific recommendations for maternal weight gain in twin and triplet pregnancy. The subjects were 1,436 mothers of twins and 227 mothers of triplets aged from 20 to 34. The following results were obtained. 1) In twin pregnancies, maternal weight gain was significantly lower in overweight women than in under- and normal-weight women. In triplet pregnancies, there was no significant difference in maternal weight gain by BMI. However, gestational week at delivery and birthweight was significantly lower in underweight women than in the normal weight women. The number of babies weighing under 1,500 g was significantly higher in underweight women than in the normal weight women. 2) In twin pregnancies, the risk of toxemia of pregnancy, baby weighting under 1,500 g, intrapartum asphyxia and preterm rupture of membrane was significantly associated with maternal weight gain. Moreover, in triplet pregnancies, toxemia of pregnancy and baby weighing under 1,500 g was significantly associated with maternal weight gain. 3) In twin pregnancies, the mean maternal weight gain in mothers without toxemia of pregnancy, and with baby weighing at least 1,500 g, was 6.2 kg at 36-37 weeks of delivery in overweight women, 12.0 kg at 37 weeks in normal women, and 12.4 kg at 36-37 weeks in the underweight women. The approximate birthweight of twins in those mothers was from 2,300 to 2,500 g. Moreover, in triplet pregnancies, the mean maternal weight gain in mothers without toxemia of pregnancy, and with baby weighing at least 1,500 g, was 12.2 kg at 35 weeks of delivery in normal weight women and 11.8 kg at 34-35 weeks in underweight women. The approximate birthweight of triplets in those mothers was from 1,800 to 2,100 g.

Body Mass Index↗
PubMedDate not supplied

Comparison of active phase labor between triplet, twin, and singleton gestations.

OBJECTIVE: To characterize the active phase of labor in triplet pregnancies and compare it with gestational age-matched twins and singletons. METHODS: Active phase rates were calculated beginning at 5 cm of dilation for women with triplet gestations longer than 24 weeks who labored and reached the second stage. Twin and singleton cohorts that also completed the first stage of labor were matched for gestational age at delivery (+/-1 week), parity, and epidural use. Intrapartum variables included oxytocin use (induction or augmentation, duration of infusion, and maximum dosage), cervical dilation at membrane rupture, and active phase dilation rate. RESULTS: Thirty-two triplet pregnancies met inclusion criteria between January 1994 and September 1998 and were each compared with twin and singleton cases in a 1:2 ratio. Triplet and twin active phase rates, while similar (1.8 versus 1.7 cm/hour, respectively), were significantly lower than the mean singleton dilation rate (2.3 cm/hour, P =.02). No other intrapartum variables differed between the three groups. Despite controlling for gestational age at delivery, mean birth weights were significantly higher in singletons and correspondingly lower in twins and triplets (2,493 versus 2,112 and 1,968 g, respectively; P =.001). An analysis of active phase dilation rates as a function of the cumulative birth weight per pregnancy demonstrated an inverse correlation, with slower progress in active labor associated with increasing total fetal weight (R = -.24; P =.002). CONCLUSIONS: Triplet and twin active phase dilation proceeds at a slower rate than that observed in singleton pregnancies. The rate of active phase dilation is inversely correlated to total fetal weight.

Birth Weight↗
PubMed2004

Triplet pregnancies in women aged 40 or older: a matched control study.

OBJECTIVE: To determine, in triplet pregnancies, if maternal age is associated with adverse outcome in terms of birth weight characteristics. STUDY DESIGN: We analyzed a nationwide cohort of live-born triplets compiled by Matria Healthcare (Marietta, Georgia). We compared all 171 mothers > or = 40 years old with randomly selected and matched-for-parity mothers aged 25-29 and 35-39 years. The main outcome measures were length of gestation and individual and total triplet birth weight. All the subjects had private health insurance. The sample size was adequate to detect 5% differences at a power of 80%. RESULTS: Birth weights for infants A, B and C were significantly higherfor mothers > or = 40 years (P = .016, .01, and .03, respectively); total triplet birth weight was significantly higher as compared with that in the younger controls (P =.01). Gestational ages were similar in the 3 groups. In addition, the frequencies of births at < 28 weeks and of < 1,000 g were reduced by one-third or more in women aged 40 or older as compared to the younger controls (2.3% vs. 6.4% and 4.5% vs. 7.0%, respectively). CONCLUSION: Older mothers of triplets have better outcomes than do their younger counterparts in terms of total triplet birth weight.

Adult↗
PubMed2005

Does maternal height affect triplets' birth weight?

BACKGROUND: In cases of triplet gestation where patients are reluctant to undergo multifetal pregnancy reduction, it would be helpful to identify predictive factors regarding poor or better outcomes. One such possible factor may be maternal height, which is possibly predictive of gestational age and neonatal birth weight. MATERIAL/METHODS: To examine such a possible association, we have retrospectively evaluated 102 triplet gestations. Maternal height and BMI were compared and correlated to neonatal weight, week of delivery, NICU hospitalization duration, and other parameters of pregnancy outcome. RESULTS: Mothers taller than 165 cm gave birth to significantly heavier neonates than shorter parturients delivered of triplets. Individual and mean total triplet neonatal weights were positively correlated to maternal height. There was no significant correlation between preconceptional maternal BMI and triplet neonatal weight and week of delivery, NICU hospitalization or any other parameter. CONCLUSIONS: The taller patient (>165 cm) may be at a significantly lower risk of very low birth weight neonates and very premature delivery as compared to the shorter patient (< 165 cm). Therefore, the factor of maternal height may be taken into consideration in multiple gestation pregnancy consultations. Smaller mothers should never receive more than two embryos in IVF programs to reduce the risk of triplets almost completely.

Birth Weight↗
PubMed1991

Multifetal reduction of triplets and pregnancy outcome.

Multifetal pregnancy reduction has been suggested as a strategy to improve pregnancy outcome in grand multiple gestations of three or more fetuses. We prospectively investigated multifetal pregnancy reduction in 13 women with triplet pregnancies in the first trimester following ovulation induction, in vitro fertilization, or gamete intrafallopian transfer procedures. Eleven women whose triplet pregnancies followed similar reproductive technologies and who declined or were not offered the procedure were managed expectantly. Mean (+/- standard deviation) infant birth weight was 2227 +/- 478 g in the multifetal reduction group and 2239 +/- 399 g in the group managed expectantly. Gestational age was 35.5 +/- 2.3 weeks in the study group and 35.7 +/- 2.5 weeks in the triplets managed expectantly. Newborn hospital days as well as newborn and maternal complications were not statistically different between the management groups. Maternal interventions included tocolytic medication, home uterine activity monitoring, and extended hospitalization, and were more common in the triplets managed expectantly than in the study group of triplets reduced to twins. Multifetal pregnancy reduction for triplet pregnancies does not necessarily improve pregnancy outcome, though it may be offered on the basis of parental choice.

Abortion, Induced↗
PubMed1991

Seasonality of triplet births in the United States.

Birth data on 1050 sets of triplets delivered in the United States from 1985 to 1988 were analyzed to establish whether seasonal variations in the number of triplet births occur. These data were compared to live birth data from the entire United States population over a similar period; the US data exhibit a seasonal variation with a peak in late summer. Seasonality in the number of triplet births was noted, and it differed significantly (p = 0.01) from that of the entire US population. A large peak in triplet births was seen in the spring (April-May) and a smaller peak in late summer (August-September). Only minor differences in these trends could be observed when triplet data were stratified by cause of pregnancy (spontaneous versus drug-induced ovulation) or corrected for the shorter gestations of triplet pregnancies.

Birth Rate↗
PubMed1991

Triplet pregnancy: changes in morbidity and mortality.

The outcome of 13 sets of triplet infants delivered between January 1, 1981, and December 31, 1988, is analyzed with specific regard to immediate neonatal morbidity. Thirty-nine viable infants were born with no perinatal deaths. Overall, 80% of triplet infants incurred some morbidity, including hyperbilirubinemia (51.3%), hypoglycemia (30.8%), respiratory distress syndrome (28.2%), respiratory compromise (23.1%), anemia (17.9%), patent ductus arteriosus (15.4%), and intraventricular hemorrhage (10.3%). All morbidities occurred in infants who averaged less than 2,000 g and 35 weeks' gestation at birth. As a background to understanding these observations, a review of reports of triplet morbidity and mortality in the United States and Europe is presented. Over the past 80 years, a continual decline in triplet perinatal mortality has occurred despite no change in the average gestational age at delivery over the past 40 years. The triplet perinatal mortality rate is now less than 10%, and prematurity is no longer as influential on perinatal mortality as it is on morbidity. Improvement in neonatal resuscitation and care and delivery by cesarean section are felt to be responsible for lower mortality rates. We believe that the optimum level of care for triplet gestations includes antenatal and neonatal care at tertiary perinatal centers and, except for special circumstances, delivery by cesarean section.

Adult↗
PubMed1991

[Birth of triplets and quadruplets in Sweden].

The management of 86 women who were delivered of triplets and 7 women who were delivered of quadruplets between 1985 and 1989 is reviewed. The incidence of triplets and quadruplets was 16.3 and 1.3 per 100,000 deliveries. All of the quadruplets and 45 per cent of the triplets were a result of medical induction of ovulation (IVF 14 per cent). The average gestational age (weeks) and the mean birth weight (gram) was 33.4 +/- 2.3/1930 +/- 450 for the triplets, and 30.0 +/- 3.8/1365 +/- 385 for the quadruplets. Cesarean section was the mode of delivery in 84 per cent of the triplets and 5 of 7 of the quadruplets. The perinatal mortality was 4.7 per cent among the triplets and 14.3 per cent among the quadruplets.

Birth Weight↗
PubMed1991

Birth weight standards for triplets under modern obstetric care in the United States, 1984-1989.

Birth data were reviewed on 3321 live-born infants from 1138 triplet pregnancies delivered in the United States between 1984-1989. The three major etiologies for the multiple gestations were fertility drugs (50%), spontaneous (38%), and in vitro methods (9%). The average length of gestation was 33.8 weeks and the mean birth weight was 1911 g. Neonatal birth weight curves for triplet infants born alive in the third trimester were plotted. From 26-35 weeks, the average triplet newborn has a weight corresponding to approximately the 30th percentile level compared with singletons. After 35 weeks, triplet birth weights fall progressively behind those of singletons, reaching the tenth percentile at 38 weeks. Multiple epidemiologic factors were analyzed to determine their effect upon neonatal birth weight and length of gestation. Factors predicting higher than average birth weight included male sex, increasing maternal age, increasing maternal height and weight, maternal weight gain, and maternal parity. The length of gestation was found to correlate with maternal age, weight gain, and parity. No significant association between fertility method and gestational age or weight could be identified. This large data base provides the first comprehensive percentile birth weight rankings for modernly managed triplet gestations in the United States population. A regression equation is presented which accurately predicts mean triplet birth weight in the third trimester and which suggests that a nearly linear weight gain of approximately 150 g per week per fetus should be expected in this period.

Adult↗
PubMed1984

A review of 367 triplet pregnancies.

Questionnaires were sent to 452 hospitals in the RSA and SWA/Namibia requesting information on triplet pregnancies over a 10-year period. Information on 367 sets of triplets from 150 hospitals was adequate for analysis. The incidence of triplets was 0,04% of all deliveries. As many as 45% of triplets were diagnosed during the first or second stage of labour. These infants had a significantly lower birth weight than those diagnosed at an antenatal clinic (P less than 0,01). The mean birth weights of babies that died in utero or neonatally (within 7 days) were significantly lower than those in survivors (P less than 0,0001). Caesarean section was the delivery method for 14% of 1 002 infants and perinatal mortality was improved for the second and third babies in comparison with second and third babies delivered vaginally (P less than 0,003 and P less than 0,002 respectively). It is concluded that the diagnosis of triplets should be made at the earliest possible stage of pregnancy, and that following adequate antenatal care all triplets should be delivered by caesarean section, except under ideal uncomplicated conditions where vaginal delivery may be feasible.

Birth Order↗
PubMed1993

Delayed birth intervals of immature fraternal triplets in preterm labor. A case report.

The preterm birth of immature triplets before 28 weeks is associated with excess morbidity and mortality risks attributable to extreme immaturity. We report a case of fraternal triplets in preterm labor in which the second and third triplet births were delayed 11 days after the first birth, at 26 4/7 weeks' gestation. The later-born sibs were heavier at birth and throughout their neonatal course in the hospital and suffered less severe complications as compared to the first-born triplet. Delayed birth intervals of triplets in preterm labor should be considered to improve perinatal salvage of immature triplets, although a successful outcome is rare and unexpected.

Adult↗
PubMed2000

Number of triplets in 16S rRNA gene related with pathogenicity of Bacillus spp. and Clostridium spp.

The relation between the number of some trinucleotides in the sequence of 16S rRNA gene and pathogenicity of bacterial species from the genera of Bacillus and Clostridium was revealed. The species of genus Bacillus, which are pathogenic for humans, mammals and insects, have an increased number of AAA and TAT triplets in 16S rRNA gene. Theoretically, these species, B. anthracis and B. cereus for example, may be detected in the specimen by the higher ratio of AAA plus TAT triplets to the number of GGG triplet. Species of genus Clostridium, which are pathogenic for humans and mammals, have a maximum ratio of AAA and TAT triplet numbers. This ratio was higher than 2.6 for pathogenic species and lower than 2.2 for saprophytic ones. These theoretical data may open a new way for detecting pathogenic bacteria through the determination of triplet numbers in the sequences of 16S rRNA or rRNA. However, the mechanism of evolutionary relation between the number of AAA and TAT triplets in the sequence of 16S rRNA gene and the pathogenicity of bacterial species is not known.

Bacillus↗
PubMed1977

Further evidence for dissipative energy migration via triplet states in photosynthesis. The protective mechanism of carotenoids in Rhodopseudomonas spheroides chromatophores.

The protection action of carotenoids against irreversible photodestruction was discovered in photosynthetic bacteria by Stanieda and coworkers. In green plant material it was found by Wolff and Witt (1969) Z. Naturforsch, 24b, 1031-1037 and (1972) Proc. 2nd. Int. Congr. Photosynthesis Res. Stresa (Forti, G., Avron, M. and Melandri, A., eds.), Vol. 2, pp. 931-936, Dr. W. Junk, N. V. Publ. The Hague) that the formation of special carotenoid triplet states (via very rapid energy transfer from excited chlorophylls) and their fast radiationless decay in tau1/2 approximately 3 microns is at least one mechanism for the protective action of carotenoids to irreversible photooxidation of the chlorophylls. Hence, it is anticipated that the same mechanism might be realized also in bacteria. The present study gives evidence for such a "triplet valve" to be established also in bacteria. This conclusion was derived from the following observations: 1. The light-induced difference spectrum shows a bleaching of a carotenoid at three characteristic wavelength between 400 and 500 nm. A positive peak around 533 nm indicates the formation of a carotenoid triplet state. 2. The absorption changes can be induced by red light which excites only bacteriochlorophyll. This indicates an energy transfer from bacteriochlorophyll to carotenoids. 3. The light-induced carotenoid triplets decay radiationless in 3 microns in air-saturated aqueous suspensions of the chromatophores. 4. The carotenoid triplet formation occurs only at actinic flash intensities where the photosynthesis becomes saturated. 5. Addition of dithionite, which blocks photosynthesis, markedly increases the extent of carotenoid triplet formation. The different types of exciton migration within the photosynthetic unit are discussed, especially the routes leading to the dissipation of excess excitation energy.

Bacterial Chromatophores↗
PubMed1981

A light-induced spin-polarized triplet detected by EPR in photosystem II reaction centers.

A light-induced spin-polarized triplet state has been detected in a purified Photosystem II preparation by electron paramagnetic resonance spectroscopy at liquid helium temperature. The electron spin polarization pattern is interpreted to indicate that the triplet originates from radical pair recombination between the oxidized primary donor chlorophyll, P-680+, and the reduced intermediate pheophytin, I-, as has been previously demonstrated in bacterial reaction centers. The dependence of the triplet signal on the redox state of I and the primary acceptor, Q, are consistent with the origin of the triplet signal from the triplet state of P-680. Redox-poising experiments indicate the presence of an endogenous donor (or donors) which operates at 3-5 K and 200 K. The zero field-splitting parameters of the triplet are very similar to those of monomeric chlorophyll a however, this alone does not allow a distinction to be made between monomeric and dimeric structures for P-680.

Chloroplasts↗
PubMed1993

Generation of electronically excited triplet species at the cellular level: a potential source of genotoxicity.

Selected enzymatic systems can efficiently produce a product in the electronically excited triplet state. Earlier, only the formation of electronically excited singlet species was known. The formation of triplet species has been demonstrated with both normal substrates/metabolites and with xenobiotics, even at the cellular level. Triplet excited species have intrinsically much longer lifetimes than excited singlets, whereby they can be potentially important agents for normal and/or deleterious processes, including mutagenesis. Enzymically generated triplet species can damage DNA, even when protein coated, as in the case of the lambda-phage of Escherichia coli. Some evidence of damage by triplet species has also been reported for intact cells. Triplet excited species may produce their effects through type I and/or type II dark photosensitization, that is, the events may be started by H abstraction and/or singlet oxygen/superoxide ion production. The induction of lipid peroxidation, with concomitant clastogenic effects, appears to be of special importance.

Acetaldehyde↗