Document Detail

First-trimester embryo size discordance: a predictor of premature birth following multifetal pregnancy reduction.
MedLine Citation:
PMID:  11172845     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: We have previously reported a correlation between the starting number of embryos for multifetal pregnancy reduction (MFPR) and discordance in size during the first trimester. Here we evaluated the correlation between the degree of discordance and length of gestation in the remaining fetuses. DESIGN: Observational clinical series. SETTING: Academic medical center with a single physician who performs a large number of MFPRs. PATIENT(S): Analysis of 252 consecutive MFPRs from a 2.5-year period (1996-1998). INTERVENTION(S): MFPR for patients with multifetal pregnancies. MAIN OUTCOME MEASURE(S): We evaluated the correlation between the degree of discordance in embryo size, as measured by the greatest difference in crown-rump length (CRL) (delta max), and the length of gestation. RESULT(S): Embryo size discordance was related to length of gestation of the remaining fetuses after MFPR. Of 72 patients with a delta max >5 mm, the rate of severe premature birth (delivery at <28 weeks' gestation) was 9.7%, compared with 1.7% for patients with a delta max <5 mm (P<.01). Of patients with severe premature birth, 70% had delta max >5 mm, compared with less than 30% in patients who delivered after 28 weeks (P<.05). CONCLUSION(S): Variations in embryo growth patterns in multifetal pregnancies may be observed even in the first trimester, which may be predictive of late pregnancy outcomes. With a delta max > or =5 mm, there is a significant increase in the risk of severe premature birth (delivery at <28 weeks).
C A Carreno; Y Yaron; B Feldman; M Treadwell; M A Ayoub; M I Evans
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Fertility and sterility     Volume:  75     ISSN:  0015-0282     ISO Abbreviation:  Fertil. Steril.     Publication Date:  2001 Feb 
Date Detail:
Created Date:  2001-02-22     Completed Date:  2001-03-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  United States    
Other Details:
Languages:  eng     Pagination:  391-3     Citation Subset:  IM    
Department of Obstetrics and Gynecology, Center for Fetal Diagnosis and Therapy, Wayne State University, Detroit, Michigan, USA.
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MeSH Terms
Crown-Rump Length
Embryo, Mammalian / anatomy & histology*
Gestational Age
Obstetric Labor, Premature / diagnosis*
Pregnancy Reduction, Multifetal*
Pregnancy, Multiple

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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