Document Detail

Follow-up of pregnancies, infants, and families after multifetal pregnancy reduction.
MedLine Citation:
PMID:  7926141     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate the course of multifetal pregnancies and also the long-term pediatric and psychosocial follow-up of surviving offspring and their parents after selective reduction. DESIGN: Follow-up study. SETTING: University hospital and subject's homes. PATIENTS: Twenty-one couples with high-order multiple pregnancies resulting from infertility treatment were referred from all over the Netherlands. A total of 36 infants (15 twins and 2 triplets) were included in the follow-up. INTERVENTION: Pregnancy reduction by transabdominal approach at a median of 11 (9 to 13) weeks gestation. One assessment took place between the age of 9 months and 6 years after delivery. MAIN OUTCOME MEASURES: Pregnancy outcome, health of the infants, and psychosocial impact upon their parents after infertility treatment and the multifetal pregnancy reduction. RESULTS: Abortion within 4 weeks after pregnancy reduction did not occur in this series. Six infants (13.7%) died perinatally. Two infants (4.4%) died at the ages of 12 days and 3 months, respectively. Early preterm delivery was the cause of death in all cases. The development of the infants was appropriate to gestational age and birth weight. At follow-up, 14 couples disclosed at the time they were unaware of the risks and the consequences of infertility treatment. Nine couples indicated they had feelings of guilt after pregnancy reduction. These feelings, however, were not disclosed at the time of the interviews, during which none of the families showed either regret or distress about their decision. Two couples only occasionally experienced some grief and mourning reactions for the reduced fetuses. CONCLUSIONS: Pregnancy reduction is an acceptable option in the case of excessive multifetal conceptions after infertility treatment regimes. There are no adverse effects on either the infants and their families provided that the procedure is carefully planned and performed and the couples are given full support both before and after the procedure.
H H Kanhai; M de Haan; L A van Zanten; C Geerinck-Vercammen; H M van der Ploeg; J B Gravenhorst
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Fertility and sterility     Volume:  62     ISSN:  0015-0282     ISO Abbreviation:  Fertil. Steril.     Publication Date:  1994 Nov 
Date Detail:
Created Date:  1994-11-18     Completed Date:  1994-11-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  955-9     Citation Subset:  IM    
Department of Obstetrics, University Medical Centre, Leiden, The Netherlands.
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MeSH Terms
Fertilization in Vitro*
Follow-Up Studies
Infertility / therapy
Ovulation Induction
Pregnancy Outcome
Pregnancy Reduction, Multifetal* / psychology
Pregnancy, Multiple

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

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