title: Pregnancy outcome after early amniotic fluid leakage after transabdominal multifetal reduction.
abstract: OBJECTIVE
  To assess the importance of amniotic fluid leakage in the early period ( < 14 days) after the fetal reduction procedure.
  
  
  METHODS
  Prospective clinical study.
  
  
  METHODS
  Pregnant women who underwent fetal reduction to twins in an academic, tertiary perinatal department.
  
  
  METHODS
  Sixty triplet and 31 quadruplet pregnancies were identified before the ninth postmenstrual week of gestation. All patients underwent transabdominal multifetal pregnancy reduction was performed within 14 days of the procedure.
  
  
  METHODS
  Transabdominal multifetal pregnancy reduction from triplets and quadruplets to twins.
  
  
  METHODS
  Amniotic fluid leakage in the early period after fetal reduction.
  
  
  RESULTS
  Early PROM occurred in eight (13.3%) patients from the triplets group and in six (19.3%) patients in the quadruplet group. Three of 60 (5.0%) patients from the triplet group and 1 of 31 (3.2%) patients from the quadruplet group miscarried before 24 weeks gestation. However, none of these patients had had PROM during the early period after the procedure. Early PROM did not influence the incidence of premature contractions of delivery and the reduction procedure, and 59% (99/169) of those who completed 24 gestational weeks delivered between 25 and 37 weeks.
  
  
  CONCLUSIONS
  The presence of amniotic fluid leakage in the period close to the multifetal reduction procedure, although alarming, is not ominous for the remaining fetuses. We see no reason for any intervention in these patients.
authors.affiliation: Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: S
authors.initials: S
authors.lastname: Lipitz
authors.forename: D
authors.initials: D
authors.lastname: Grisaru
authors.forename: R
authors.initials: R
authors.lastname: Achiron
authors.forename: A
authors.initials: A
authors.lastname: Lidor
authors.forename: S
authors.initials: S
authors.lastname: Mashiach
authors.forename: E
authors.initials: E
authors.lastname: Schiff
mesh_terms: D000022:Abortion, Spontaneous / Q000209:etiology; D000328:Adult; D000653:Amniotic Fluid / Q000502:physiology*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000209:etiology*; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D018607:Pregnancy Reduction, Multifetal / Q000009:adverse effects*; D011272:Pregnancy, Multiple; D011446:Prospective Studies