Multifetal reduction of high-order multiple pregnancy: comparison of obstetrical outcome with nonreduced twin gestations.
OBJECTIVE
To compare the obstetric outcomes of twin pregnancies obtained as a result of multifetal pregnancy reduction to those in which pregnancy reduction had not been used.


METHODS
Retrospective analysis.


METHODS
University-based tertiary care infertility clinic.


METHODS
Seventy-four twin pregnancies continuing beyond 10 weeks. Of these, 32 gestations had undergone reduction to twins at 10 weeks.


METHODS
Gestational age at delivery, birth weights, pregnancy complications.


RESULTS
All pregnancies advanced beyond 20 weeks gestation. The mean gestational age at delivery of the reduction group was 33.8 versus 35.7 weeks in the nonreduced group; only 25% of reduced pregnancies reached 37 weeks compared with 57.9% of nonreduced twins. The mean fetal birth weights of the two groups differed significantly (reduced: 2,038 g, nonreduced: 2512 g). The gestational age at delivery in patients reduced from triplets was significantly greater than in pregnancies reduced from quadruplets or higher. Multiple regression analysis revealed that for a given gestational age at delivery, a history of pregnancy reduction was associated with decreased birth weight.


CONCLUSIONS
These data suggest that multifetal pregnancy reduction does not reverse completely the decreased gestational age and impaired fetal growth associated with high-order multiple pregnancy. Furthermore, fetal growth of reduced pregnancies seems to be impaired independent of the gestational age at which delivery occurs.
Alexander
J M
JM
Department of Obstetrics and Gynecology, University of Alabama at Birmingham 35233-7333, USA.
Hammond
K R
KR
Steinkampf
M P
MP
D000328:Adult; D001724:Birth Weight; D005260:Female; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D018607:Pregnancy Reduction, Multifetal / Q000009:adverse effects*; D011272:Pregnancy, Multiple; D012044:Regression Analysis