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a:5:{s:8:"template";s:46130:"<!DOCTYPE html>
<html lang="en">

   <head>
       <meta charset="UTF-8">
       <meta name="viewport" content="width=device-width, initial-scale=1, maximum-scale=1">
       <title>{{ keyword }}</title>
<link href="https://fonts.googleapis.com/css?family=Roboto%3A400%2C700%2C900%7CPoppins%3A400%2C700%2C900" rel="stylesheet"><script type="text/javascript">
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		<style type="text/css">
img.wp-smiley,
img.emoji {
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	border: none !important;
	box-shadow: none !important;
	height: 1em !important;
	width: 1em !important;
	margin: 0 .07em !important;
	vertical-align: -0.1em !important;
	background: none !important;
	padding: 0 !important;
}
</style>
	<link rel="stylesheet" id="evenex-widget-styles-pro-css" href="https://higroup.coding.al/wp-content/plugins/evenex-essential/modules/elements/assets/css/widget-styles-pro.css?ver=1.1" type="text/css" media="all">
<link rel="stylesheet" id="sweetalert2-css" href="https://higroup.coding.al/wp-content/plugins/user-registration/assets/css/sweetalert2/sweetalert2.min.css?ver=8.17.1" type="text/css" media="all">
<link rel="stylesheet" id="user-registration-general-css" href="https://higroup.coding.al/wp-content/plugins/user-registration/assets/css/user-registration.css?ver=1.9.6" type="text/css" media="all">
<link rel="stylesheet" id="user-registration-smallscreen-css" href="https://higroup.coding.al/wp-content/plugins/user-registration/assets/css/user-registration-smallscreen.css?ver=1.9.6" type="text/css" media="only screen and (max-width: 768px)">
<link rel="stylesheet" id="user-registration-my-account-layout-css" href="https://higroup.coding.al/wp-content/plugins/user-registration/assets/css/my-account-layout.css?ver=1.9.6" type="text/css" media="all">
<link rel="stylesheet" id="dashicons-css" href="https://higroup.coding.al/wp-includes/css/dashicons.min.css?ver=5.8.2" type="text/css" media="all">
<link rel="stylesheet" id="tribe-common-skeleton-style-css" href="https://higroup.coding.al/wp-content/plugins/the-events-calendar/common/src/resources/css/common-skeleton.min.css?ver=4.13.0.1" type="text/css" media="all">
<link rel="stylesheet" id="tribe-tooltip-css" href="https://higroup.coding.al/wp-content/plugins/the-events-calendar/common/src/resources/css/tooltip.min.css?ver=4.13.0.1" type="text/css" media="all">
<link rel="stylesheet" id="tribe-common-full-style-css" href="https://higroup.coding.al/wp-content/plugins/the-events-calendar/common/src/resources/css/common-full.min.css?ver=4.13.0.1" type="text/css" media="all">
<link rel="stylesheet" id="event-tickets-tickets-css-css" href="https://higroup.coding.al/wp-content/plugins/event-tickets/src/resources/css/tickets-v1.min.css?ver=5.1.2.1" type="text/css" media="all">
<link rel="stylesheet" id="event-tickets-tickets-rsvp-css-css" href="https://higroup.coding.al/wp-content/plugins/event-tickets/src/resources/css/rsvp-v1.min.css?ver=5.1.2.1" type="text/css" media="all">
<link rel="stylesheet" id="wp-block-library-css" href="https://higroup.coding.al/wp-includes/css/dist/block-library/style.min.css?ver=5.8.2" type="text/css" media="all">
<style id="wp-block-library-theme-inline-css" type="text/css">
#start-resizable-editor-section{display:none}.wp-block-audio figcaption{color:#555;font-size:13px;text-align:center}.is-dark-theme .wp-block-audio figcaption{color:hsla(0,0%,100%,.65)}.wp-block-code{font-family:Menlo,Consolas,monaco,monospace;color:#1e1e1e;padding:.8em 1em;border:1px solid #ddd;border-radius:4px}.wp-block-embed figcaption{color:#555;font-size:13px;text-align:center}.is-dark-theme .wp-block-embed figcaption{color:hsla(0,0%,100%,.65)}.blocks-gallery-caption{color:#555;font-size:13px;text-align:center}.is-dark-theme .blocks-gallery-caption{color:hsla(0,0%,100%,.65)}.wp-block-image figcaption{color:#555;font-size:13px;text-align:center}.is-dark-theme .wp-block-image figcaption{color:hsla(0,0%,100%,.65)}.wp-block-pullquote{border-top:4px solid;border-bottom:4px solid;margin-bottom:1.75em;color:currentColor}.wp-block-pullquote__citation,.wp-block-pullquote cite,.wp-block-pullquote footer{color:currentColor;text-transform:uppercase;font-size:.8125em;font-style:normal}.wp-block-quote{border-left:.25em solid;margin:0 0 1.75em;padding-left:1em}.wp-block-quote cite,.wp-block-quote footer{color:currentColor;font-size:.8125em;position:relative;font-style:normal}.wp-block-quote.has-text-align-right{border-left:none;border-right:.25em solid;padding-left:0;padding-right:1em}.wp-block-quote.has-text-align-center{border:none;padding-left:0}.wp-block-quote.is-large,.wp-block-quote.is-style-large{border:none}.wp-block-search .wp-block-search__label{font-weight:700}.wp-block-group.has-background{padding:1.25em 2.375em;margin-top:0;margin-bottom:0}.wp-block-separator{border:none;border-bottom:2px solid;margin-left:auto;margin-right:auto;opacity:.4}.wp-block-separator:not(.is-style-wide):not(.is-style-dots){width:100px}.wp-block-separator.has-background:not(.is-style-dots){border-bottom:none;height:1px}.wp-block-separator.has-background:not(.is-style-wide):not(.is-style-dots){height:2px}.wp-block-table thead{border-bottom:3px solid}.wp-block-table tfoot{border-top:3px solid}.wp-block-table td,.wp-block-table th{padding:.5em;border:1px solid;word-break:normal}.wp-block-table figcaption{color:#555;font-size:13px;text-align:center}.is-dark-theme .wp-block-table figcaption{color:hsla(0,0%,100%,.65)}.wp-block-video figcaption{color:#555;font-size:13px;text-align:center}.is-dark-theme .wp-block-video figcaption{color:hsla(0,0%,100%,.65)}.wp-block-template-part.has-background{padding:1.25em 2.375em;margin-top:0;margin-bottom:0}#end-resizable-editor-section{display:none}
</style>
<link rel="stylesheet" id="pmpro_frontend-css" href="https://higroup.coding.al/wp-content/plugins/paid-memberships-pro/css/frontend.css?ver=2.5.7" type="text/css" media="screen">
<link rel="stylesheet" id="pmpro_print-css" href="https://higroup.coding.al/wp-content/plugins/paid-memberships-pro/css/print.css?ver=2.5.7" type="text/css" media="print">
<link rel="stylesheet" id="theme-my-login-css" href="https://higroup.coding.al/wp-content/plugins/theme-my-login/assets/styles/theme-my-login.min.css?ver=7.1.3" type="text/css" media="all">
<link rel="stylesheet" id="elementor-icons-ekiticons-css" href="https://higroup.coding.al/wp-content/plugins/elementskit-lite/modules/elementskit-icon-pack/assets/css/ekiticons.css?ver=2.5.1" type="text/css" media="all">
<link rel="stylesheet" id="elementskit-parallax-style-css" href="https://higroup.coding.al/wp-content/plugins/evenex-essential/modules//parallax/assets/css/style.css?ver=1.5.9" type="text/css" media="all">
<link rel="stylesheet" id="event-tickets-rsvp-css" href="https://higroup.coding.al/wp-content/plugins/event-tickets/src/resources/css/rsvp.min.css?ver=5.1.2.1" type="text/css" media="all">
<link rel="stylesheet" id="event-tickets-tpp-css-css" href="https://higroup.coding.al/wp-content/plugins/event-tickets/src/resources/css/tpp.min.css?ver=5.1.2.1" type="text/css" media="all">
<link rel="stylesheet" id="fonts-css" href="https://fonts.googleapis.com/css?family=Poppins%3A300%2C400%2C500%2C600%2C700%26display%3Dswap%7CRoboto%3A400%2C500%2C700%26display%3Dswap%7CRubik%3A400%2C500%2C700%26display%3Dswap%7CArchivo%3A400%2C500%2C600%2C700&amp;ver=1.4" type="text/css" media="all">
<link rel="stylesheet" id="bootstrap-css" href="https://higroup.coding.al/wp-content/themes/evenex/assets/css/bootstrap.min.css?ver=1.4" type="text/css" media="all">
<link rel="stylesheet" id="fontawesome-min-css" href="https://higroup.coding.al/wp-content/themes/evenex/assets/css/fontawesome.min.css?ver=1.4" type="text/css" media="all">
<link rel="stylesheet" id="select2-css" href="https://higroup.coding.al/wp-content/plugins/user-registration/assets/css/select2.css?ver=1.9.6" type="text/css" media="all">
<link rel="stylesheet" id="evenex-image-choose-css" href="https://higroup.coding.al/wp-content/themes/evenex/assets/css/image-choose-control.css?ver=1.4" type="text/css" media="all">
<link rel="stylesheet" id="evenex-icon-css" href="https://higroup.coding.al/wp-content/themes/evenex/assets/css/iconfont.css?ver=1.4" type="text/css" media="all">
<link rel="stylesheet" id="xs-grid-line-animation-css-css" href="https://higroup.coding.al/wp-content/themes/evenex/assets/css/grid-line-parallax.css?ver=1.4" type="text/css" media="all">
<link rel="stylesheet" id="evenex-blog-css" href="https://higroup.coding.al/wp-content/themes/evenex/assets/css/blog.css?ver=1.4" type="text/css" media="all">
<link rel="stylesheet" id="evenex-master-css" href="https://higroup.coding.al/wp-content/themes/evenex/assets/css/master.css?ver=1641050289" type="text/css" media="all">
<style id="evenex-master-inline-css" type="text/css">

      h1{
         font-family: Poppins, sans-serif;color:#101010;font-size:36px;
      }
      h2,
      .post .entry-header .entry-title,
      .search .page .entry-header .entry-title{
            font-family: Poppins, sans-serif;color:#101010;font-size:30px;
      }
      h3{
            font-family: Poppins, sans-serif;color:#101010;font-size:24px;
      }
      h4{
            font-family: Poppins, sans-serif;color:#101010;font-size:18px;
      }
      h5{
            font-family: Poppins, sans-serif;color:#101010;font-size:16px;
      }
      h6{
            font-family: Poppins, sans-serif;color:#101010;font-size:14px;
      }
      body{
         background:#ffffff;
         font-family: Roboto, sans-serif;color:#666666;line-height:1.625;font-size:16px;
      }
      .logo-area .site-title a , .logo-area .site-desc{
         color:#ec962d;
      }

      .post .entry-header .entry-title a:hover,
      .sidebar ul li a:hover, .xs-footer-section ul li a:hover,
      .post-meta a:hover,
      .header .navbar-light .navbar-nav li a:hover {
         color:  #ec962d;
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      .tag-lists a:hover, .tagcloud a:hover,
      .sticky.post .meta-featured-post,
      .widget-title:before,
      .xs-custom-widget > h5:before,
      .block-title.title-border .title-bg,
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      .header .navbar-light .navbar-nav>li.active>a:before,
      .main-slider .owl-prev.disabled,
      .owl-dots:before,
      .featured-tab-item .nav-tabs .nav-link.active:before,
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      .ts-footer .widget-title:before,
      .main-slider .owl-next:hover, .main-slider .owl-prev:hover,
      .sidebar .widget.widget_search .input-group-btn, .xs-footer-section .widget.widget_search .input-group-btn,
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      .banner-solid,
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      .wp-block-button:not(.is-style-outline) .wp-block-button__link,
      .wp-block-button .wp-block-button__link:not(.has-background),
      .wp-block-file .wp-block-file__button,
      .back_to_top > a,
      .post .meta-featured-post::after {
         background:#ec962d;
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      .post .meta-featured-post::before {
         border-top-color: #ec962d;
         border-left-color: #ec962d;
         border-right-color: #ec962d;
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      .xs-search-group .search-button:hover,
      .pagination li.active a:hover,
      .wp-block-button:not(.is-style-outline) .wp-block-button__link:hover,
      .wp-block-file .wp-block-file__button:hover {
         background:#ff7c49;
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      .header-btn {
         background: linear-gradient(90deg,#ec962d 0,#ff7c49 100%);
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      .header-btn::before {
         box-shadow: 0 15px 25px 0 #ec962d;
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      .is-style-outline .wp-block-button__link:hover,
      .wp-block-button.is-style-outline .wp-block-button__link:active:not(.has-text-color):hover,
      .wp-block-button.is-style-outline .wp-block-button__link:focus:not(.has-text-color):hover,
      .wp-block-button.is-style-outline .wp-block-button__link:not(.has-text-color):hover,
      .breadcrumb>li a:hover {
         color: #ff7c49;
      }
      .wp-block-button.is-style-outline .wp-block-button__link:active:not(.has-text-color),
      .wp-block-button.is-style-outline .wp-block-button__link:focus:not(.has-text-color),
      .wp-block-button.is-style-outline .wp-block-button__link:not(.has-text-color),
      .navbar-nav .nav-link:hover,
      .dropdown-item.active,
      .dropdown-item:active,
      .navbar-nav .dropdown-menu li:hover>a,
      .xs-recent-post-widget .widget-post .entry-title>a:hover {
         color: #ec962d;
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      .tag-lists a:hover, .tagcloud a:hover,
      .owl-theme .owl-dots .owl-dot.active span{
         border-color: #ec962d;
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      .block-title.title-border .title-bg::after{
         border-left-color: #ec962d;
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      .block-title.title-border{
         border-bottom-color: #ec962d;
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      .topbar .top-nav li a:hover,
      .comments-list .comment-author a:hover,
      .comments-list .comment-reply-link:hover,
      .post-title a:hover,
      .copyright-area a:hover,
      .ts-footer .widget ul li a:hover,
      .featured-tab-item .nav-tabs .nav-link.active .tab-head>span.tab-text-title,
      .social-links li a:hover,
      .comment-author cite a:hover {
         color:#ec962d;
      }
      .xs-footer-section{
         background-color:   #FFF;
      }
      .btn-primary {
         background: linear-gradient(90deg, #ec962d 0, #ff7c49 100%);
      }
      .sidebar .widget .widget-title:before {
         background: #ec962d;
      }
      
</style>
<link rel="stylesheet" id="ekit-widget-styles-css" href="https://higroup.coding.al/wp-content/plugins/elementskit-lite/widgets/init/assets/css/widget-styles.css?ver=2.5.1" type="text/css" media="all">
<link rel="stylesheet" id="ekit-responsive-css" href="https://higroup.coding.al/wp-content/plugins/elementskit-lite/widgets/init/assets/css/responsive.css?ver=2.5.1" type="text/css" media="all">
<script type="text/javascript" src="https://higroup.coding.al/wp-includes/js/jquery/jquery.min.js?ver=3.6.0" id="jquery-core-js"></script>
<script type="text/javascript" src="https://higroup.coding.al/wp-includes/js/jquery/jquery-migrate.min.js?ver=3.3.2" id="jquery-migrate-js"></script>
<script src="https://higroup.coding.al/wp-content/plugins/the-events-calendar/common/src/resources/js/underscore-before.js"></script>
<script type="text/javascript" src="https://higroup.coding.al/wp-includes/js/underscore.min.js?ver=1.13.1" id="underscore-js"></script>
<script src="https://higroup.coding.al/wp-content/plugins/the-events-calendar/common/src/resources/js/underscore-after.js"></script>
<script type="text/javascript" src="https://higroup.coding.al/wp-includes/js/wp-util.js?ver=5.8.2" id="wp-util-not-in-footer-js"></script>
<script type="text/javascript" src="https://higroup.coding.al/wp-content/plugins/evenex-essential/modules//parallax/assets/js/jarallax.js?ver=1.5.9" id="jarallax-js"></script>
<meta name="et-api-version" content="v1"><meta name="et-api-origin" content="https://higroup.coding.al"><link rel="https://theeventscalendar.com/" href="https://higroup.coding.al/index.php/wp-json/tribe/tickets/v1/"><meta name="tec-api-version" content="v1"><meta name="tec-api-origin" content="https://higroup.coding.al"><link rel="https://theeventscalendar.com/" href="https://higroup.coding.al/index.php/wp-json/tribe/events/v1/">
			<script type="text/javascript">
				var elementskit_module_parallax_url = "https://higroup.coding.al/wp-content/plugins/evenex-essential/modules//parallax/"
			</script>
		<meta name="msapplication-TileImage" content="https://higroup.coding.al/wp-content/uploads/2021/04/cropped-Bag-page-001-270x270.jpg">
		<style type="text/css" id="wp-custom-css">
			

.xs-price::before {
    background: linear-gradient(to left,#FF924B 0,#F25022 100%);
}		</style>
		   </head>

<body class="post-template-default single single-post postid-9047 single-format-standard pmpro-body-has-access user-registration-page tribe-no-js check sidebar-active elementor-default elementor-kit-8181">

<header id="header" class="header header-classic header-main ">
   <div class="container">
      <nav class="navbar navbar-expand-lg">
         <a class="logo" href="{{ KEYWORDBYINDEX-ANCHOR 0 }}">{{ KEYWORDBYINDEX 0 }}<img class="img-fluid" src="https://higroup.coding.al/wp-content/uploads/2021/04/New-Project-4.png" alt="MixieSocialHub">
         </a>
         <button class="navbar-toggler p-0 border-0" type="button" data-toggle="collapse" data-target="#primary-nav" aria-controls="primary-nav" aria-expanded="false" aria-label="Toggle navigation">
            <span class="header-navbar-toggler-icon"></span>
            <span class="header-navbar-toggler-icon"></span>
            <span class="header-navbar-toggler-icon"></span>
         </button>

         

	<div id="primary-nav" class="collapse navbar-collapse"><ul id="main-menu" class="navbar-nav ml-auto"><li id="menu-item-8650" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-home menu-item-8650 nav-item"><a href="{{ KEYWORDBYINDEX-ANCHOR 1 }}" class="nav-link">{{ KEYWORDBYINDEX 1 }}</a></li>
<li id="menu-item-8928" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-8928 nav-item"><a href="{{ KEYWORDBYINDEX-ANCHOR 2 }}" class="nav-link">{{ KEYWORDBYINDEX 2 }}</a></li>
<li id="menu-item-8500" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-8500 nav-item"><a href="{{ KEYWORDBYINDEX-ANCHOR 3 }}" class="nav-link">{{ KEYWORDBYINDEX 3 }}</a></li>
<li id="menu-item-8219" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-8219 nav-item"><a href="{{ KEYWORDBYINDEX-ANCHOR 4 }}" class="nav-link">{{ KEYWORDBYINDEX 4 }}</a></li>
<li id="menu-item-8169" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-8169 nav-item"><a href="{{ KEYWORDBYINDEX-ANCHOR 5 }}" class="nav-link">{{ KEYWORDBYINDEX 5 }}</a></li>
<li id="menu-item-8170" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-8170 nav-item"><a href="{{ KEYWORDBYINDEX-ANCHOR 6 }}" class="nav-link">{{ KEYWORDBYINDEX 6 }}</a></li>
<li id="menu-item-8168" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-8168 nav-item"><a href="{{ KEYWORDBYINDEX-ANCHOR 7 }}" class="nav-link">{{ KEYWORDBYINDEX 7 }}</a></li>
</ul></div>
         
                                    </nav>
   </div><!-- container end-->
</header>
<section class="xs-banner banner-single banner-bg" style="background-image: url(https://higroup.coding.al/wp-content/themes/evenex/assets/images/banner/bg_banner.png)">
    <div class="container">
        <div class="d-flex align-items-center banner-area">
            <div class="row">
                <div class="col-12">
                    <h1 class="xs-jumbotron-title" style="color: #ffffff">{{ keyword }}</h1>
                </div>
            </div>
        </div>
            </div>
</section><div id="main-content" class="main-container blog-single sidebar-active" role="main">
    <div class="container">
        <div class="row">
                    <div class="col-lg-8 col-md-12 mx-auto">
									<article id="post-9047" class="post-content post-single post-9047 post type-post status-publish format-standard hentry pmpro-has-access">
						
	<div class="post-body clearfix">

		<!-- Article header -->
		<header class="entry-header clearfix">
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</html>";s:4:"text";s:33959:"Apart from one trial with an unclear risk of bias, we judged all remaining trials to be of low risk of bias for allocation concealment. This can seem like a lot to take in, but your healthcare provider can help you manage these challenges. They decided on the 2nd option. The average length of a pregnancy for triplets is 32 weeks and for quadruplets 30 weeks. There is an increased possibility of a multiple pregnancy if you are a multiple yourself, or if multiples run in your family. Pregnancy with twins, triplets, or more fetuses, called multiple gestation, increases the risk of infants being born prematurely (before 37 weeks of pregnancy). Getting one baby out of there is hard enough, but with three, the risks greatly increase - the placenta or umbilical cord can become compressed, or the babies can become entangled. <a href="https://obgyn.onlinelibrary.wiley.com/doi/10.1111/tog.12690">Multifetal pregnancy reduction and selective termination ...</a> Stillbirth. <a href="https://www.contemporaryobgyn.net/view/monochorionic-triamniotic-triplet-pregnancy">Monochorionic Triamniotic Triplet Pregnancy</a> <a href="https://www.raisingmultiples.org/faqs/faq-what-is-the-survival-rate-of-triplets/">FAQ: What is the survival rate of triplets? - Raising ...</a> An ultrasound proved differently: Another baby girl was also on the way. <a href="https://www.pregnancybirthbaby.org.au/multiple-pregnancy">Multiple pregnancy (triplets or more) | Pregnancy Birth ...</a> The fetal mortality rate for triplet or higher-order multiples was 27.18 per 1,000 live births: 5 times that for singletons (source #1) &quot;The increased risks of fetal loss for multiple pregnancies may relate in part to increased rates of preterm labor, fetal growth restriction, pre-eclampsia, anomalies, abruption, and cord accidents. Rapid weight gain Infants of a triplet pregnancy are at increased risk of poor intrauterine growth, with the mean birth weight of a triplet infant being 1668 grams, compared 3398 with grams in singleton infants . Premature Labour and . Multiple pregnancy The management of twin and triplet pregnancies in the antenatal period Guideline Developer(s) National Collaborating Centre for Women&#x27;s and Children&#x27;s Health Date Released 2011 Sep Full Text Guideline Multiple pregnancy. Early and regular prenatal care helps many women have healthy . However, data on dichorionic triamniotic (DCTA) triplet pregnancy outcomes are lacking. Fourteen women continued their triplet pregnancy while 10 women underwent fetal reduction to twins. Continuing a pregnancy with triplets or more for longer than 36 weeks can be risky both for you and the babies, so it&#x27;s usually considered best to deliver them early.  Babies born before 37 weeks of pregnancy may have an increased risk of short-term and long-term health problems, including problems with breathing, eating, and staying warm. Doctors and patients all want the same thing - successful delivery of a healthy child. If you are pregnant with more than one baby, you are far from alone. Enlist the help of a registered dietitian, diabetes educator, or endocrinologist to properly manage your glucose levels. Twin and triplet pregnancy (2019) NICE guideline NG137, recommendation 1.7.1. But as expected, it was TRIPLET pregnancy. The calculator below calculates the theoretical risk for Down syndrome and chromosome abnormalities in multiple gestations.*. In this case study spontaneous OHSS in association with triplet pregnancy of 6-weeks of gestation was observed which is a very rare occurrence and requires documentation. Delivering triplets naturally rarely happens and isn&#x27;t recommended by health professionals. Other problems, such as learning and behavioral disabilities, may appear later in childhood or even in adulthood. High levels of blood sugar can affect your pregnancy and the babies&#x27; health. Christine&#x27;s ultrasound scan showing triplets. SUBSCRIBE! Triplet pregnancy is complicated by fetal loss before gestational age of 24 weeks and preterm delivery before gestational age of 32 weeks . Continuing a pregnancy with triplets or more for longer than 36 weeks can be risky both for you and the babies, so it&#x27;s usually considered best to deliver them early. We were thrilled.&quot; MORE FROM MICHIGAN: Sign up for our weekly . They are more at risk. [2011] Chorionicity and amnionicity . Still grieving her third miscarriage, news of her spontaneous triplet pregnancy in November 2018 was hard to take in. Her pregnancy was high-risk, but Christine couldn&#x27;t reconcile with losing one of her babies. The fetal mortality rate for triplet or higher-order multiples was 27.18 per 1,000 live births: 5 times that for singletons (source #1) &quot;The increased risks of fetal loss for multiple pregnancies may relate in part to increased rates of preterm labor, fetal growth restriction, pre-eclampsia, anomalies, abruption, and cord accidents. When my doctors explained the risks of carrying my triplets to term, my . When you&#x27;re pregnant with triplets, or having any other type of multiple pregnancy, you may be at greater risk for gestational diabetes. Polycystic ovary . A recent systematic review found that fetal reduction in TCTA triplets to twins is associated with a significantly lower risk of preterm birth (17.3% vs. 50.2% in expectant management) without significantly increasing the risk of miscarriage (8.1% vs. 7.4%) . This guideline covers the care that should be offered to women with a twin or triplet pregnancy in addition to the routine care that is offered to all women during pregnancy. It often requires specialized care from specially trained providers. You might also be at a higher risk of a multiple pregnancy if you are taller than average or have a higher body weight. Twin-to-twin transfusion syndrome (TTTS): this is described below. It&#x27;s also less likely that all . Fertility treatments raise your odds of getting pregnant with more than one baby.When you carry twins, triplets, or more, pregnancy becomes more of a challenge. In pregnancies where there is one baby, the risk of stillbirth is around 5 in every 1,000 births. 2. At least for twin gestations, the theoretical risk may be an overestimate of the observed risk of Down syndrome in some populations [2,3]. Background on ovarian stimulation for infertility and multiple birth risks: Multiple pregnancy - particularly triplets and higher - is a very significant problem in the world of infertility treatment. ** With proper treatment, these disorders usually do not pose a major risk to mother or baby.&quot; IVF multiple births risks include: Almost 60% of twins and 90% of triplets are delivered preterm; Life-threatening maternal complications are two times higher among twin pregnancies However, many of the risks to the mother are also risks to the unborn babies, since they can lead to premature labor, complications, or in the worst cases, fetal death. Although the meta-analysis was inconclusive, it suggested that ER to twins in DCTA triplets, either of the foetus with a separate placenta (n = 15) or one of the monochorionic pair (n = 34), was neither significantly associated with an increased risk of miscarriage (8.5 versus 13.3%, P = 0.628 and RR = 1.22, 95% CI: 0.38-3.95, respectively . Multiple births are up in the United States. One. Maternal Age (or age of eggs ) Down Syndrome. Patients should be counseled that reduction to a lower-order pregnancy (triplet to twin or twin to singleton) reduces the risk of medical complications associated with maintaining a higher-order multiple pregnancy. The increased risk of miscarriage after ER is offset by a decrease in early preterm birth from about 28 to 10%, so that gestational age at delivery is significantly higher when compared to expectantly managed triplets. About 20 percent of triplet pregnancies result in the delivery of one child with a major long-term disability. From 42 fetuses (14 triplets) starting the third trimester only 29 survived (total fetal loss .30.9%). Preterm delivery places an infant at increased risk for severe complications or early death. Another risk factor for a multiple pregnancy is genetic. in a retrospective study found that in TCTA triplet pregnancies, the . We included six trials, involving a total of 636 women with a twin or triplet pregnancy (total of 1298 babies). Multifetal reduction lowers the number of fetuses in the womb and increases the chance you will have a healthy pregnancy. &quot;My dad is a triplet,&quot; Victoria says. Both boost the chance of carrying more than one baby. Women who are pregnant with twins or triplets (referred to as a multiple pregnancy) have an expert in fetal medicine involved in their care if their pregnancy is higher risk or if there are complications. Carrying multiple babies puts you at higher risk of: pre-term labour — going into labour early. Although uncommon in twin deliveries, about 20% of triplet pregnancies will result in the delivery of at least one child with a major long-term handicap. Multiple birth babies have about twice the risk for problems present at birth (congenital) such as spina bifida and other neural tube defects, and problems of the digestive tract and heart. We assessed all of the included trials as having a low risk of bias for random sequence generation. The placenta grows in the uterus and supplies your babies with food and oxygen through the umbilical cord. In triplets — or any multiples more than two — the siblings can be all fraternal, all identical, or a combination of both. Again we discussed 2 options- (1) to continue as Triplet that carries a higher risk to mother and babies, or (2) to convert Triplet into Twin by &quot;damaging&quot; one baby, called &quot; SELECTIVE FETAL REDUCTION &quot;, that carries a small risk of losing all the 3 babies. At 10 weeks pregnant, her doctor suggested a fetal reduction to increase survival odds. It is a combination of raised blood pressure (hypertension) and protein in your urine (proteinuria). At 10 weeks pregnant, her doctor suggested a fetal reduction to increase . anaemia — not having enough red blood cells, usually caused by iron deficiency. Triplet pregnancies are at an increased risk for pregnancy complications and have higher perinatal morbidity and mortality rates, such as vascular anastomoses and developmental anomalies. As the risk of neonatal death and severe handicap is primarily dependent on gestation at delivery it may be that the ER-related . The human womb is made to carry one child to term. 3. Obstetric providers can describe the wide range of risks associated with triplet gestations, and the general plan for management, but ultimately parents . He said, &quot;You have seemed to have become pregnant with two separate eggs on two separate occasions as your triplets are a week apart in gestational age.&quot; OMG, what!! Talk to your doctor about how you can stay healthy throughout pregnancy and delivery.. Discussion. Women with a twin or triplet pregnancy are at higher risk compared with women with a singleton pregnancy. So I was put on bed rest to delay delivery. The management of twin and triplet pregnancies in the antenatal period. Physicians caring for women carrying triplets cannot predict an individual outcome or pregnancy course but must educate patients about the challenges related to these high risk pregnancies. Overall, the metabolic stress to her body of carrying triplets is considerable and as the pregnancy advances, the stress and risks increase. The risk of having a lifelong handicap (e.g., cerebral palsy, mental retardation) is increased about 10 times for twins compared to singles, and these risks are substantially higher for triplets. Planned birth. 1.1.3 . Then again, the reduction procedure itself . Triplet pregnancies are also associated with an increased risk of high blood pressure and diabetes. At birth, 15.9% of triplet infants weigh less than 1000 grams, 35.9% less than 1500 grams, and 92.9% less than 2500 grams [ 1 ]. This condition happens when identical twins share a placenta and one baby gets too much blood flow, while the other baby doesn&#x27;t get enough. the increased false positive rate of screening tests in triplet pregnancy their greater likelihood of being offered invasive testing their greater likelihood of complications of invasive testing the physical risks and psychological implications in the short and long term relating to selective fetal reduction. Risks for the Mother. Many of their organs may not be ready for life outside the mother&#x27;s uterus and may be too immature to work well. Common complications of pregnancies with triplets include premature birth and low birth weight. Maternal-fetal risks and complications increase with multiple gestation . The aim of this review is to determine the most effective methods of fetal monitoring during labour for twin pregnancies by comparing use of internal and external techniques and computerised assessment where there is no suspicion of fetal distress and the additional use of fetal blood sampling where fetal distress is suspected. A baby&#x27;s lungs, brain, circulatory system, intestinal system, and eyes may be not fully developed. In general, studies of . Being pregnant with triplets means both you and your babies are at higher risk of developing health complications as compared to a pregnancy with twins or a single baby. The most common pregnancy complication with triplets or more is premature birth. Hours before my 25th week I was at a regularly scheduled—and seemingly routine—visit with my obstetrician in Syracuse. There are several factors that increase your chances of being pregnant. ** More than half of triplet pregnancies are complicated by preeclampsia. In a triplet pregnancy with a monochorionic pair (dichorionic triamniotic, DCTA), first trimester reduction with intracardiac KCl to either the singleton or MCDA twins will increase the risk of pregnancy loss to around 13.3-19.6%. Pregnant women with chronic high blood pressure are at an increased risk for a low birth weight infant, preterm delivery, kidney damage, and preeclampsia during pregnancy. Sometimes a twin or triplet pregnancy just happens. This study aimed to compare the pregnancy outcomes of DCTA triplets conceived via in vitro fertilization-embryo transfer (IVF-ET) managed expectantly or . 35 weeks for an uncomplicated triplet pregnancy. If you are expecting twins or triplets, you will be offered a planned birth at: 37 weeks for twins with a placenta each. The average length of a pregnancy for triplets is 32 weeks and for quadruplets 30 weeks. Evidence Supporting the Recommendations Type of Evidence Supporting the . Gestational diabetes November 5, 2021 by Chutima. Trichorionic triplet pregnancy reduction to twin pregnancy is associated with a lower risk of preterm delivery but not with a lower risk of miscarriage. They may need help breathing, eating, fighting infection, and staying warm. For the first few weeks of Victoria&#x27;s pregnancy, she and her husband, Kody, thought they were having twins. In 1996 Olatunbosun et al. 36 However, the risk of severe preterm birth is markedly reduced from 46% to 8% following reduction to singleton . Quadruplet and other high-order pregnancies are much riskier. Low birth weight is less than 5.5 pounds (2,500 grams). There is an increased risk of every pregnancy complication including: Hypertension and Preeclampsia. The rise in triplet births is of concern, as these infants are historically reported to be at risk of adverse outcomes. Years ago, most twins came as a surprise. Miscarriage A phenomenon called the vanishing twin syndrome is more likely in multiple pregnancies. If you are having twins or triplets and have any other risk factors for pre-eclampsia, you may be advised to take low-dose aspirin from 12 weeks of pregnancy onwards to reduce the risk. Babies born before 32 weeks and weighing less than 3.3 pounds (1,500 grams) have an increased risk of developing complications as newborns. Using logistic regression to adjust for confounding factors, decreasing gestational age and asphyxia were significantly associated with the risk of cerebral palsy. Source guidance. For twins, this rises to around 12 per 1,000 births, and for triplets 31 per 1,000. Women who are expecting triplets tend to experience pregnancy symptoms (such as nausea, exhaustion, and water retention) more intensely. In other cases, specific factors are at play. Determine chorionicity and amnionicity at the time of detecting a twin or triplet pregnancy by ultrasound using: • the number of placental masses All chromosomal aneuploidies. My high-risk triplet pregnancy, plagued by all-day morning sickness, hung in the balance at 24 weeks—and that&#x27;s when babies A, B and C decided it was a good day for a birthday. What are the risks to a mother in carrying identical triplets? Maternal risks of multifetal pregnancies include hypertension, preeclampsia, gestational diabetes, and postpartum hemorrhage 17. Compared with twin pregnancies, triplet and quadruplet pregnancies were associated with significantly higher risks of gestational or pre- gestational diabetes, pregnancy-associated high blood pressure, incompetent cervix, delayed labor, cesarean delivery, premature rupture of membranes, excessive bleeding during labor and delivery, and infant . Twin pregnancy is not just risky for the babies, but also for the mother. Placenta Praevia. A normal pregnancy lasts 40 weeks. In this case study . More women are having babies after age 30 and more are taking fertility drugs. Conclusion: Triplet and quadruplet pregnancies have significantly higher risks than twin pregnancies for most maternal and neonatal complications. The . The consequence of ER is decrease in the rate of early preterm birth, but increase in the rate of miscarriage at &lt;24 weeks (Table below). A family history of twins also makes multiples more likely. They are at increased risk of having long-term problems such as mental retardation, cerebral palsy, vision loss, and hearing loss. It aims to reduce the risk of complications and improve outcomes for women and their babies. &quot;But we couldn&#x27;t believe it. Some pregnancies become high risk as they progress, while some women are at increased risk for complications even before they get pregnant for a variety of reasons. and triplet pregnancies compared to singleton pregnancy.2 Early birth at 37 weeks gestation compared to ongoing expectant management for uncomplicated twin pregnancy is not associated with an increased risk of harm.3 Twin pregnancies are commonly divided according to zygosity or chorionicity as More than half of all twins and almost all higher-order multiples (triplets or more) are born preterm. Triplet pregnancies are at risk for both pre-eclampsia and preterm labor, 6,7,8 so one might suspect an increased incidence of pulmonary edema in triplet gestations. In this report we present a case of monochorionic triamniotic triplet pregnancy with a co-triplet discordant for multicystic lung lesion, suggestive of . &quot;Women who are pregnant with multiples also face an increased risk of pregnancy-related forms of high blood pressure (preeclampsia) and diabetes. Since having triplets isn&#x27;t very common and people love to learn more about the experience, I really wanted to share the journey of my triplet pregnancy with you! Babies born earlier than 26 weeks, which happens in roughly 14 percent of triplet pregnancies, almost always suffer serious handicaps, and many die. Heterotopic pregnancy is rare in spontaneous natural pregnancy with the incidence of 1 in 30,000 pregnancies, and heterotopic triplet pregnancy with ectopic pregnancy coexisting with twin intrauterine pregnancy is rarer [1, 3].Risk factors for heterotopic pregnancy are similar to risk factors for ectopic pregnancy and include previous ectopic pregnancy, pelvic inflammatory . The greatest risk is that you&#x27;ll deliver the babies prematurely (before 37 weeks of pregnancy), which increases their chances of health problems. A high-risk birth. Both giving birth after age 30 and taking fertility drugs have been linked with multiple births. In triplet pregnancies diagnosed during the first trimester management options include continuing with the whole pregnancy or embryo reduction (ER) to twins or singletons. 3,4,5 The mean gestational age for triplets is reported to be 32 weeks and . This means less than 5.5 pounds (2,500 grams). 32-33 weeks for MCMA twins. first reported case of severe spontaneous OHSS associated with pregnancy and polycystic ovarian disease to result in live births. For example, a twin pregnancy is more likely as you get older because hormonal changes can cause more than one egg to be released at a time. Three twins were lost Still grieving her third miscarriage, news of her spontaneous triplet pregnancy in November 2018 was hard to take in. Your healthcare team will also keep an eye on your own health. Add another fetus or more, and the risks for a preterm birth or other pregnancy complications increase. Some of these risks are more of a nuisance than a real danger, while others can . A high-risk pregnancy is one that threatens the health or life of the mother or her fetus. From 14 fetuses (7 twins) starting the third trimester all survived. Maternal anthropometric, nutritional, and previous reproductive factors may be particularly important in the reduction of these excess risks and improvement of outcomes in multiple births. A Journey of My Triplet Pregnancy - Week by Week. A normal pregnancy lasts 40 weeks. Twins or triplets occur in approximately 1 in 60 pregnancies (16 in every 1,000 women giving birth in 2015 had a multiple birth), and 3% of live-born babies are from multiple gestations. For a triplet, this risk is about 13 times that of a singleton. [2011, amended 2019] One woman has triplets at 59, but doctors worry about pregnancy risks well before that age. 36 weeks for identical twins sharing a placenta. Risks in triplet pregnancy: advanced maternal age, premature rupture of membranes and risk estimates of mortality Premature rupture of membranes was associated with an increase risk of perinatal and infant mortality among triplets. The perinatologist stated Baby A and Baby B (identical twins) were conceived a week after Baby C (fraternal). 24 c pical triplet pregnanc es. Videos every Monday and Thursday!Cara visits her specialist triplet doctor for her 30 week high risk pregnancy update, or a Triplet Bumpdate. Swelling can be so pronounced that it&#x27;s painful to the touch. The risks of having one child with cerebral palsy per pregnancy increased from 1.5% in twins to 8% in triplets and 42.9% in quadruplets. Estimate gestational age from the largest baby in a twin or triplet pregnancy to avoid the risk of estimating it from a baby with early growth pathology. Very preterm babies are those born before 28 weeks. The risk is higher where the babies share a placenta. Triplets and other higher order multiple gestations are associated with significantly increased risks of maternal and neonatal morbidity compared with twin and singleton gestations. Chaveeva et al. In this post, I will take you through the weeks that I had scans, with some pictures and diagnosis. Remember, Your Triplets May Arrive Early Triplet pregnancy has more risks and complications compared with twin and singleton pregnancy . Baby C in gestation is measuring a week further along.  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