Multifetal pregnancy reduction and selective termination: the Canadian experience.
OBJECTIVE
To describe the experience of two Canadian referral centres with multifetal pregnancy reduction (MFPR) and selective termination (ST).


METHODS
Retrospective chart review of all MFPR and ST procedures during the periods from January 1, 1990, to December 31, 1997 (Vancouver), and from September 1, 1995, to December 31, 1997 (Toronto). Outstanding outcome data were obtained by telephone. All women were managed according to standard protocols. Non-parametric analysis of continuous variables and Fisher's exact test for categorical variables were used.


RESULTS
61 women underwent transabdominal MFPR (n = 44) or ST (n = 17). Median maternal age: MFPR and ST 33.0 years; gestational age at reduction: MFPR 11.4, ST 20.2 weeks; procedure duration: MFPR 4, ST 10 min. 89% MFPR and 12% ST cases followed assisted reproduction. 7% MFPR and 18% ST pregnancies lost <24 weeks (n.s.). 97% MFPR and 83% ST non-reduced fetuses delivered alive. Median delivery gestational age: MFPR and ST 37 weeks.


CONCLUSIONS
The results are similar to published series. This procedure has increased options for Canadian couples, offering the procedure 'close to home', reducing costs and, more importantly, the significant psychological morbidity following these procedures.
von Dadelszen
P
P
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology and Fetal Diagnosis and Treatment Centre, University of Toronto, Ont., Canada.
Johnson
J A
JA
Farquharson
D F
DF
Wilson
R D
RD
Seaward
P G
PG
D000328:Adult; D002170:Canada; D005260:Female; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D018607:Pregnancy Reduction, Multifetal; D011272:Pregnancy, Multiple; D012099:Reproductive Techniques; D012189:Retrospective Studies