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.