Outcome of early versus late multifetal pregnancy reduction.

Abstract:

:Multifetal pregnancy reduction (MPR) is an accepted method of reducing complications of triplet pregnancies and higher-order multifetal pregnancies. Eighty-three pregnancies that underwent early (68 weeks) transvaginal MPR were compared with 125 pregnancies that underwent late (11-14 weeks) transabdominal MPR. Rates of pregnancy loss, preterm delivery, gestational diabetes and hypertensive disorders were similar among both groups. Early MPR was associated with a lower risk for small for gestational age newborns (6.5% versus 19.2%; P = 0.034; OR 0.32; 95% CI 0.11 to 0.92) and a higher risk for single-fetus loss (6% versus 0.8%; P = 0.041; OR 10.58; 95% CI 1.1 to 101.94). Preterm delivery rates seemed to be similar between the two groups. In MPR from triplets, an apparent benefit was observed for early MPR in preterm deliveries before 37 weeks, whereas, in MPR from high-order pregnancies, a benefit was observed for late MPR in deliveries before 32 weeks. Perinatal outcomes of twin pregnancies after early and late MPR seem to be grossly similar. Optimal timing for multifetal reduction depends on other factors, namely, the selectivity of the procedure and patient's preference.

journal_name

Reprod Biomed Online

authors

Haas J,Barzilay E,Hourvitz A,Dor J,Lipitz S,Yinon Y,Shlomi M,Shulman A

doi

10.1016/j.rbmo.2016.08.015

subject

Has Abstract

pub_date

2016-11-01 00:00:00

pages

629-634

issue

5

eissn

1472-6483

issn

1472-6491

pii

S1472-6483(16)30463-1

journal_volume

33

pub_type

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