Document Detail


Retain singleton or twins? Multifetal pregnancy reduction strategies in triplet pregnancies with monochorionic twins.
MedLine Citation:
PMID:  23274040     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To assess the effectiveness and feasibility of retaining a singleton or twins for multifetal pregnancy reduction (MFPR) in triplet pregnancy with monochorionic twins. STUDY DESIGN: This retrospective study was conducted from January 2006 to September 2011 at a university reproductive medical center. Multifetal pregnant patients (n=35) with dichorionic triplets underwent MFPR in the first trimester to reduce one or both monochorionic twins. These cases were divided into two groups: Group A (9 MFPR cases to reduce one monochorionic twin) and Group B (26 MFPR for both monochorionic twins). Control A (for Group A) included another 18 cases of trichorionic triplet reduction to twins; Control B (for Group B) included 35 cases of trichorionic triplet reduction to singletons. MFPR was performed during the same period for all groups. Pregnancy outcomes were compared between groups. RESULTS: Patients were 28-39 years old; the average gestation for fetal reduction was 6-8 weeks. The early abortion rate was lower in Group A than Group B (0 versus 11.5%, p=0.339), but the late abortion rate was significantly higher in Group A. (33.3% versus 0, p=0.000). Groups A and B did not differ significantly in premature labor rate, term birth rate, gestation at delivery and take-home baby rate. The rate of very low and low birth weight was significantly higher in Group A than Group B (50% versus 0, p=0.001), and the average birth weight was significantly lower in Group A (2391.7±318.5 versus 3119.6±523.9, p=0.001). Group A had significantly more low birth-weight newborns than Control A (50% versus 13.3%, p<0.05 [0.024]). Group B (retained singleton) had similar pregnancy outcomes and neonatal conditions as Control B. CONCLUSIONS: Retaining a singleton is always the best choice when deciding about using MFPR to improve pregnancy outcomes. For patients having a triplet pregnancy with monochorionic twins and strongly desiring to keep twins, MFPR in one monochorionic twin was feasible by aspirating embryonic parts early in gestation (6-8 weeks) with no drug injection. Pregnancy outcomes are similar with twin reduction in trichorionic triplet pregnancy.
Authors:
Rong Li; Xinna Chen; Shuo Yang; Rui Yang; Caihong Ma; Ping Liu; Jie Qiao
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-26
Journal Detail:
Title:  European journal of obstetrics, gynecology, and reproductive biology     Volume:  -     ISSN:  1872-7654     ISO Abbreviation:  Eur. J. Obstet. Gynecol. Reprod. Biol.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375672     Medline TA:  Eur J Obstet Gynecol Reprod Biol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Obstetrics and Gynecology, Reproductive Medical Center, Peking University Third Hospital, Beijing, China.
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