The effects of multiple gestation and selective reduction on fetal outcome.
A group of 32 women with at least 3 or more viable fetuses by sonography at approximately 8 weeks gestation were given the option of selective reduction. They were advised that this was a relatively new procedure but heretofore in a small series was not associated with a significant increase in fetal demise. Only 7 of 32 women chose this option. six of these 7 had triplets reduced to twins, 1 woman had quadruplets reduced to twins. Thirteen of 14 viable babies were successfully delivered at a mean of 36.8 weeks gestation; 2 of 7 (28.6%) delivered before 37 weeks. In contrast, 7 of 25 (24%) not having reduction lost all babies (6 triplets, 1 quadruplet). Four other women lost at least 1 of their gestations (total of 5 babies). Pre-term deliveries (< 37 weeks) occurred in 16 of 18 (88.8%) patients delivering at least 1 live baby, with a mean of 33.7 weeks gestation. Thus the high rate of total fetal loss and prematurity for multiple gestation and the low pregnancy wastage and pre-term delivery rate following selective reduction might make the latter a reasonable therapeutic option to patients interested in having the best chance of delivering healthy viable babies.
Check
J H
JH
University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School at Camden, New Jersey.
Nowroozi
K
K
Vetter
B
B
Rankin
A
A
Dietterich
C
C
Schubert
B
B
D000032:Abortion, Therapeutic / Q000009:adverse effects*; D016009:Chi-Square Distribution; D005260:Female; D005313:Fetal Death / Q000209:etiology; D006801:Humans; D009017:Morbidity; D007752:Obstetric Labor, Premature / Q000209:etiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D011272:Pregnancy, Multiple; D011783:Quadruplets; D014310:Triplets; D016216:Ultrasonography, Prenatal