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Triplets and More

Higher-order multiple pregnancies (more than two fetuses) have become more common with advances in infertility treatment. Up to 30 percent of patients who undergo fertility treatments will conceive twins or more.

We will monitor you carefully with ultrasound screenings and regular visits to your doctor or midwife.

Risks to the fetuses

  • Risks of preterm birth, death of a baby in the uterus, stillbirth and slow growth are more common among this group.
  • Gestational age (age of the fetus) is the most important factor in determining risks. The average gestational age for twins is 35 weeks, 33 weeks for triplets, and 31 weeks for quadruplets.
  • Compared with a single pregnancy, there is a higher chance that a multiple pregnancy will have one or more fetuses with a birth defect.

Risks to the mother

  • Up to 98 percent of patients with triplets will experience some complication during the pregnancy. You may need to decrease your activity or be hospitalized.
  • The risks of preterm labor, premature rupture of membranes, preeclampsia, gestational diabetes, anemia, and a serious liver problem are all higher.
  • You may be very physically uncomfortable at the end of your pregnancy and become unable to take care of yourself.
  • There is a higher risk of hemorrhage, infection or hospital readmission, so you may be advised to have a cesarean section.
  • Marital stress can be significant for parents expecting triplets or more.

Multifetal pregnancy reduction (MFPR)

  • This procedure is for women carrying triplets or more. It is best done around 11 weeks, but may be done as late as 20 weeks. It is done by injecting potassium chloride into the weakest fetuses, which would then become absorbed by the mother's system, leaving the one or two strongest fetuses and greatly increasing their chances of survival.
  • MFPR carries an 8 percent risk of losing the entire remaining pregnancy before 24 weeks.

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