| Selective reduction and termination of multiple pregnancies. | |
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MedLine Citation:
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PMID: 20863776 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The substantial increase in high order multiple pregnancies in the last two decades as a result of assisted reproductive techniques has necessitated the development of multifetal pregnancy reduction as a management tool to decrease fetal number and improve perinatal survival. The evidence in favour of reduction in pregnancies with more than four fetuses to twins is undisputed. Despite the recent improvements in expectant management of triplets with reasonable perinatal outcomes, the evidence suggests that reduction to twins significantly reduces the risk of preterm delivery without an increase in miscarriage rates. Recent advances in vascular-occlusive techniques have allowed the possibility of selective termination in monochorionic pregnancies in the presence of discordant anomalies or indeed multifetal reduction in non-trichorionic triplets, with radiofrequency ablation and cord occlusion appearing to be the most successful. However, the techniques vary in complexity and complication rates, which increase with gestation. Hence the need to refer these pregnancies early to specialist centres. |
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Authors:
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R C Wimalasundera |
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Publication Detail:
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Type: Journal Article; Review Date: 2010-09-22 |
Journal Detail:
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Title: Seminars in fetal & neonatal medicine Volume: 15 ISSN: 1878-0946 ISO Abbreviation: Semin Fetal Neonatal Med Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-10-18 Completed Date: 2011-02-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101240003 Medline TA: Semin Fetal Neonatal Med Country: Netherlands |
Other Details:
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Languages: eng Pagination: 327-35 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 Elsevier Ltd. All rights reserved. |
Affiliation:
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Centre for Fetal Care, Queen Charlotte's & Chelsea Hospital, Imperial College Healthcare Trust, Du Cane Road, London W12 0HS, UK. r.wimalasundera@imperial.ac.uk |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Catheter Ablation Chorion Decision Making Embolization, Therapeutic Female Gestational Age Humans Laser Coagulation Pregnancy Pregnancy Outcome Pregnancy Reduction, Multifetal / adverse effects, methods* Triplets Twins, Monozygotic |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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