Document Detail

Selective termination and elective reduction in twin pregnancies: 10 years experience at a single centre.
MedLine Citation:
PMID:  9756315     Owner:  NLM     Status:  MEDLINE    
Selective termination is employed in multifetal pregnancies, in the presence of an abnormal fetus, in order to improve the prognosis of the normal fetuses. The term elective reduction is used to describe reduction in twin pregnancies for maternal medical conditions, psychological, or socioeconomic reasons. The purpose of this study was to evaluate the factors that influence outcome in such pregnancies. Eighty-two twin pregnancies underwent selective termination (n = 59) or elective reduction (n = 23) over a 10-year period. Early procedures, performed < or = 14 weeks (n = 31), had a pregnancy loss of 9.7% and a mean procedure-to-loss interval of 4.1 +/- 2.8 weeks; mean birthweight was 3299 +/- 395 g in survivors, with a mean gestational age at delivery of 38.4 +/- 2.3 weeks. In comparison, procedures performed > 14 weeks (n = 51) had a pregnancy loss of 7.8%, with a procedure-to-loss interval of 1.2 +/- 0.6 weeks. Mean birthweight was 2577 +/- 999 g, with a mean gestational age at delivery of 35.7 +/- 5 weeks. In conclusion, outcomes were more favourable among patients who underwent a first trimester procedure. The slight increase in pregnancy loss may be attributed to a higher than expected rate of spontaneous abortions in the first trimester, as manifested by the higher procedure-to-loss interval after a first trimester procedure. These facts underscore the importance of early detection of fetal abnormalities in twin pregnancies by ultrasonography and chorionic villus sampling.
Y Yaron; K D Johnson; P K Bryant-Greenwood; R L Kramer; M P Johnson; M I Evans
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  13     ISSN:  0268-1161     ISO Abbreviation:  Hum. Reprod.     Publication Date:  1998 Aug 
Date Detail:
Created Date:  1998-12-17     Completed Date:  1998-12-17     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  2301-4     Citation Subset:  IM    
Center for Fetal Diagnosis and Therapy, Department of Obstetrics and Gynecology, Hutzel Hospital/Wayne State University, Detroit, MI, USA.
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MeSH Terms
Abortion, Spontaneous / etiology
Birth Weight
Congenital Abnormalities / diagnosis
Diseases in Twins / diagnosis
Ethics, Medical
Fertilization in Vitro
Gestational Age
Oocyte Donation
Ovulation Induction
Pregnancy Outcome
Pregnancy Reduction, Multifetal* / adverse effects,  methods
Pregnancy Trimester, First
Pregnancy Trimester, Second
Pregnancy, Multiple*
Prenatal Diagnosis

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