Today. Three years ago.

This is the first Boston Hospital special care nursery admission for baby girl Last-Name A. She is the 2360 g product of a 35.7 week triple gestation. These triplets were spontaneous triplets. They are monochorionic triamniotic. The middle triplet was noted to have a sacral meningomyelocele with associated dilated lateral ventricles and marked ventriculomegaly. The delivery was a planned cesarean section and this triplet was in breech presentation. She emerged with a good cry. Her Apgar scores were 8 and 9 at 1 and 5 minutes. She was then transferred to the special care nursery for further management.

This is a 35-week gestation preemie first of triplets who is doing well. We will keep her in the special care nursery for at least 24 hours. We will monitor for apnea and bradycardia. We will monitor for hyperglycemia and we will continue to offer p.o. feedings as tolerated, and will watch closely for hypoglycemia.

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This is the first Boston Hospital admission for Anna who is admitted with known meningomyelocele at 35.7 weeks of gestational age. She was born weighing 2195 g. Triplets were spontaneous and considered identical. This baby was diagnosed antenatally with a sacral meningomyelocele and dilated lateral ventricles on a 30-week ultrasound. Delivery was via scheduled cesarean section. Apgar scores for this triplet were 9 and 9 at 1 and 5 minutes respectively. The baby emerged vigorous with spontaneous cry. The meningomyelocele was dressed with sterile Kerlix with normal saline, wrapped with NeoWrap and the baby remained in a prone position.

This is a 35.7 week triplet female with known myelomeningocele who appears well. There are dilated lateral ventricles by perinatal ultrasound. The cranial ultrasound and MRI had been ordered; however, Dr. B. would like to do the repair prior to the brain studies. Baby is currently n.p.o on total fluids of 60 cc/kg/day. Due to being an infant of a diabetic mother, we will follow glucoses closely. Follow up for hyperbilirubinemia clinically. Blood culture and CBC have been sent. Perioperative antibiotics will be given, pending consultation with neurosurgery. Parents have been updated by the team and have met with anesthesia and pediatric neurosurgery.

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This is the first Boston Hospital special care nursery admission for baby girl Last-Name Triplet C. Baby girl Last-Name Triplet C is a 2180 g product of a 35.7 week gestation. These triplets were conceived spontaneously and are monochorionic and triamnionic. It was noted that triplet B had sacral myelomeningocele with dilated lateral ventricle. The triplets were born by elective cesarean section. This triplet was born at 10:59 am. She was in breech position.

This is a newborn triplet at 35 weeks, who is doing well. We will observe her in the special care nursery for at least 24 hours, at which point, she may be transferred to the regular nursery if she remains stable. We will continue to monitor blood sugars. We will p.o. feed as tolerated.

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Happy Birthday, my loves!