Document Detail


Obstetric outcome and psychological follow-up of pregnancies after embryo reduction.
MedLine Citation:
PMID:  10438446     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The obstetric outcome and psychological follow-up of the parents after embryo reduction performed at Sahlgrenska University Hospital between 1993 and 1997 in 13 women treated for infertility is described. A comparison is made with non-reduced multiple pregnancies, both spontaneous and multiple pregnancies after assisted reproduction technology. Altogether 10 triplets, two quadruplets and one quintuplet pregnancy underwent embryo reduction. The surgical procedure was performed in gestation week 7-8 by transvaginal, ultrasound-guided aspiration of embryonic tissue. The psychological follow-up included personal interviews and psychological evaluations by a Psychological General Well-being Scale (PGWB) and Beck's Depression Inventory (BDI). In 11 cases reduction was performed to twin pregnancies. In two cases of triplets after in-vitro fertilization and transfer of two embryos, reduction was performed on the monozygotic, monochorionic twins. No complete miscarriages occurred. Ten women delivered twins and three women delivered singletons. The mean gestation length was 40.4 weeks for singletons and 35.9 weeks for twins. The mean birthweight was 3411 g for singletons and 2392 g for twins. No complications related to the reduction were detected in the children.The psychological follow-up showed that the psychological well-being of the parents was good. However, the events around the reduction were experienced as chaotic and emotionally disturbing. One woman regretted the reduction. All couples emphasized that avoidance of high order pregnancies should be of primary importance. In conclusion, embryo reduction appears to improve the perinatal outcome of multiple pregnancies obtained after assisted reproduction technology. It is important that the surgical procedure is performed at a centre with experience of this type of intervention, by a limited number of surgeons and in a regulated manner. Psychologically, however, the intervention is traumatic and psychological management is essential for good final outcome.
Authors:
C Bergh; A Möller; L Nilsson; M Wikland
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  14     ISSN:  0268-1161     ISO Abbreviation:  Hum. Reprod.     Publication Date:  1999 Aug 
Date Detail:
Created Date:  1999-09-21     Completed Date:  1999-09-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  2170-5     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Göteborg University, S-413 45 Göteborg, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Fertilization in Vitro* / adverse effects
Humans
Male
Pregnancy
Pregnancy Outcome
Pregnancy Reduction, Multifetal* / psychology
Pregnancy, Multiple* / physiology,  psychology

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