Document Detail

Efficacy of transabdominal multifetal pregnancy reduction: collaborative experience among the world's largest centers.
MedLine Citation:
PMID:  8515927     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate the safety and efficacy of transabdominal multifetal pregnancy reduction (MFPR) in the management of iatrogenic and spontaneous multifetal pregnancies. METHODS: Data were combined from 463 completed pregnancies that underwent MFPR at major worldwide centers. RESULTS: Multifetal pregnancy reduction was performed with a 100% technical success rate (there were no failed procedures); 83.8% had delivery of potentially viable fetuses (defined as 24 weeks' gestation or later), and 83.5% of these viable pregnancies delivered at 33 weeks or later. The risk of fetal loss was 3.9% at 2 weeks or less post-procedure, 4.6% at 4 weeks or less, and 16.2% at less than 24 weeks of gestation. Gestational age at delivery varied principally with the number of fetuses remaining, with 7.1% delivering prematurely at less than 28 weeks, and 9.4% at 29-32 weeks. The incidence of obstetric and medical complications appeared to be unaffected, and there was no increase in congenital malformations. CONCLUSIONS: Multifetal pregnancy reduction is an efficient and safe way of improving outcome in multifetal pregnancies, unambiguously for quadruplets or more, and arguably for triplets. However, particularly at higher starting numbers, there are still suboptimal outcomes. We cannot answer the question of whether MFPR should be offered to women with triplets or twins. The only major risk appears to be fetal loss per se, and because the procedure itself does not damage the survivors, parental autonomy should be given a higher priority in the decision process than previously. However, to obviate the need for this procedure, infertility specialists must continue to be vigilant in the use of fertility drugs.
M I Evans; M Dommergues; R J Wapner; L Lynch; Y Dumez; J D Goldberg; I E Zador; K H Nicolaides; M P Johnson; M S Golbus
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  82     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  1993 Jul 
Date Detail:
Created Date:  1993-07-22     Completed Date:  1993-07-22     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  61-6     Citation Subset:  AIM; IM    
Department of Obstetrics/Gynecology, Hutzel Hospital/Wayne State University School of Medicine, Detroit, Michigan.
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MeSH Terms
Abortion, Induced* / adverse effects,  methods
Abortion, Spontaneous / etiology
Gestational Age
Infant, Newborn
Infertility, Female / therapy
Pregnancy Complications
Pregnancy, Multiple*
Risk Factors

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