Document Detail


First-trimester multifetal pregnancy reduction: evaluation of technical aspects and risks from 2,756 cases in the literature.
MedLine Citation:
PMID:  9813417     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the technical aspects, efficacy and safety of first-trimester multifetal pregnancy reduction in the management of multifetal pregnancies, an analysis of the international literature on first-trimester multifetal pregnancy reduction was made. MATERIALS: Thirty-three studies were selected from an international review of the literature. Total fetal loss rate, risk of fetal loss after the procedure with the different techniques and gestational age at delivery were the main parameters studied. The Kruskal-Wallis test and Mann-Whitney test were used for statistical analysis. RESULTS: 2,756 multifetal pregnancy reductions were performed (2,145 transabdominal, 363 transcervical, and 248 transvaginal procedures). Total fetal loss rates were different: 16.7% for the transabdominal, 24.8% for the transcervical and 10.9% for the transvaginal procedure (p = 0.03). The risk of fetal loss was 12% for the transabdominal, 20% for the transcervical, and 10% for the transvaginal approach at less 24 weeks of gestation (p = 0.04). There was no difference for the gestational age at the time of the procedure, the initial and final number of embryos, and the gestational age at delivery. CONCLUSION: Because the transvaginal approach seems to be the safer procedure, surgeons may opt for it. The transcervical approach has a high fetal loss rate and should be excluded.
Authors:
H Dechaud; M C Picot; B Hedon; P Boulot
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Fetal diagnosis and therapy     Volume:  13     ISSN:  1015-3837     ISO Abbreviation:  Fetal. Diagn. Ther.     Publication Date:    1998 Sep-Oct
Date Detail:
Created Date:  1998-12-23     Completed Date:  1998-12-23     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9107463     Medline TA:  Fetal Diagn Ther     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  261-5     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Fetal Medicine Unit, Arnaud de Villeneuve Hospital, Montpellier, France. hdechaud@mnet.fr
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MeSH Terms
Descriptor/Qualifier:
Abortion, Spontaneous
Female
Gestational Age*
Humans
Pregnancy
Pregnancy Reduction, Multifetal* / adverse effects,  methods
Pregnancy Trimester, First
Pregnancy, Multiple
Risk Factors

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


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