The outcome of the multifetal pregnancy reduction procedures in a single centre: A report of 202 completed cases

Eur J Obstet Gynecol Reprod Biol. 2018 Nov:230:22-27. doi: 10.1016/j.ejogrb.2018.09.008. Epub 2018 Sep 11.

Abstract

Objective: To review the results of fetal reduction procedures in our institution, evaluate its effects on the pregnancy outcome in terms of miscarriage, preterm delivery, taking home healthy babies and discuss the factors that may have contributed to the outcome.

Study design: This is a retrospective study performed at the Fetal Medicine Unit of the Sisli Memorial Hospital in Istanbul after ART therapies in our unit from 2000 to 2011.

Results: The sample comprised 151 triplets, 35 quadruplets, 11 quintuplets, 3 twins, 1 sextuplet and 1 septuplet. The average maternal age was 30 ± 4.4 and the average week of interventions was 11.7 ± 1.3 weeks. In 40 cases two or more needle insertions were necessary. The two-week post-procedure loss rate, defined as 'the procedure related loss rate', was 0.7%; however, for the whole sample, the losses were 6.9% when they occured before 24 completed weeks and was defined as 'the total loss rate'. 184 of the remaining 188 cases had at least one baby to take home (91.1% of 202 patients). The average birth week for those healthy babies discharged home was 35.5 ± 2.4. The rate of early preterm birth before gestational weeks of 32 was 9%. The mean birthweight of this "take-home" group was 2302 ± 525 g.

Conclusion: Fetal reduction in multifetal pregnancy is associated with low miscarriage rate and preterm delivery rates. Fetal reduction in multifetal pregnancy should be considered for better pregnancy outcomes and the results of this study can be used in prenatal counseling.

Keywords: Fetal reduction; Miscarriage; Multifetal pregnancyy; Preterm delivery.

MeSH terms

  • Abortion, Spontaneous / epidemiology*
  • Abortion, Spontaneous / etiology
  • Adult
  • Birth Weight
  • Female
  • Gestational Age
  • Humans
  • Live Birth
  • Pregnancy
  • Pregnancy Reduction, Multifetal / adverse effects
  • Pregnancy Reduction, Multifetal / methods*
  • Pregnancy Reduction, Multifetal / statistics & numerical data
  • Pregnancy, Multiple
  • Premature Birth / epidemiology*
  • Premature Birth / etiology
  • Prenatal Care / methods*
  • Prenatal Care / statistics & numerical data
  • Retrospective Studies
  • Treatment Outcome