title: Multifetal pregnancy reduction: evaluation of fetal growth in the remaining twins.
abstract: OBJECTIVE
  Our purpose was to study fetal growth after reduction of high-order multiple gestations to twins.
  
  
  METHODS
  Birth weight and gestational age data were collected for 236 triplet and greater multiple pregnancies reduced to twins (113 triplets, 89 quadruplets, and 34 quintuplets or above) and was compared with those of a control group of unreduced twins.
  
  
  RESULTS
  Rates of intrauterine growth restriction per pregnancy were significantly different between the nonreduced and all categories of reduced multifetal pregnancies. The incidence of intrauterine growth restriction was 19.4% in the nonreduced twins, 36.3% in pregnancies reduced from triplets, 41.6% in pregnancies reduced from quadruplets, and 50% from higher-order multiple gestations. There was a statistically significant trend toward increasing frequency of intrauterine growth restriction with increasing starting fetal number (p = 0.04). The increase in intrauterine growth restriction was primarily accounted for by twin pairs with only one growth-restricted newborn.
  
  
  CONCLUSIONS
  Multifetal pregnancy reduction does not reduce the incidence of intrauterine growth restriction in the remaining fetuses to that of nonreduced twins.
authors.affiliation: Department of Obstetrics and Gynecology, Jefferson Medical College, Philadelphia, PA 19107, USA.
authors.forename: R
authors.initials: R
authors.lastname: Depp
authors.forename: G A
authors.initials: GA
authors.lastname: Macones
authors.forename: M F
authors.initials: MF
authors.lastname: Rosenn
authors.forename: E
authors.initials: E
authors.lastname: Turzo
authors.forename: R J
authors.initials: RJ
authors.lastname: Wapner
authors.forename: V J
authors.initials: VJ
authors.lastname: Weinblatt
mesh_terms: D001724:Birth Weight; D004200:Diseases in Twins; D005314:Embryonic and Fetal Development; D005260:Female; D005317:Fetal Growth Retardation / Q000517:prevention & control; D006801:Humans; D011247:Pregnancy; D018607:Pregnancy Reduction, Multifetal; D011272:Pregnancy, Multiple; D014427:Twins