Triplets conjures up equal thoughts of amazement and dread at having to grow then look after three babies at once. St Vincent’s Private has had a triplet delivery this week which was very exciting for all – not just the prospective parents. Luckily Mum has had a relatively uncomplicated pregnancy and all the babies came out in great condition and are doing well.
The chance of spontaneous triplets is about 1 in 6400 compared to spontaneous twins at about 1 in 80. IVF has increased the rates of multiple births in Australia, particularly twins, but triplets are also possible if two embryos are placed and one of them splits.
Triplet pregnancies obviously have to be observed closely as unfortunately the risk of just about every complication of pregnancy is increased. Downs screening is trickier as some of the usual tests cannot be applied. Nausea and vomiting of early pregnancy can be much worse and the risk of miscarriage is increased. Iron and calcium supplementation is a must as three babies will soon deplete the mother of these things.
Diabetes testing is performed earlier in the pregnancy also as they are at greater risk of this. The growth of the babies is closely watched with ultrasound every 2-4 weeks depending on whether they each have their own sacs and placentas or share them. It is less risky if they all have their own sac and placenta – sharing is not encouraged in utero!
Once the pregnancy gets past 20 weeks the biggest risks are pre term labour and one or more of the babies not growing properly necessitating the delivery of all the babies.
As many deliveries of triplets would occur prior to 32 weeks most are delivered in tertiary hospitals with a NICU for the babies. As the triplets at St Vincent’s Private have grown well and reached 34 weeks it will be very safe to deliver them here as they will be in the hands of great paediatricians and nurses in the Special Care Nursery.
Most obstetricians would deliver triplets by about 34 weeks as the risk of the babies health declining after this increases. In twin pregnancies most would be delivered by around 38 weeks. Obviously with three babies it can get quite uncomfortable for the mother as well.
At delivery which is by Caesarean Section the theatre is particularly crowded as each baby requires its own cot and midwife and two paediatricians will be present as well as the usual theatre staff and obstetricians.
I think delivery will be the easy bit for this mum – it will be the next five years that will be busy!
Note: The triplets were delivered by Dr Vanessa King. Dr King has also provided this blog post, with permission from the family.