Second-trimester multifetal pregnancy reduction facilitates prenatal diagnosis before the procedure.
OBJECTIVE
To evaluate the pregnancy outcome of selective second-trimester multifetal pregnancy reduction (MFPR) compared to first-trimester MFPR.


METHODS
Cohort analysis.


METHODS
In Vitro Fertilization Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.


METHODS
The study groups comprised 38 and 70 patients who underwent selective second-trimester MFPR (group 1) and first-trimester MFPR (group 2) at mean gestational ages of 19.7 +/- 3.3 weeks and 11.7 +/- 0.7 weeks, respectively.


METHODS
Ultrasonographically guided intracardiac injection of potassium chloride (KCl) solution.


METHODS
Pregnancy outcome and obstetric complications.


RESULTS
No statistically significant difference was found between group 1 and group 2 regarding mean gestational age at delivery (35.4 +/- 3.4 weeks and 35.9 +/- 3.1 weeks, respectively); mean birth weight (2,318.9 +/- 565.7 g and 2, 138.1 +/- 529.4 g); and the incidence of obstetric complications. These complications included pregnancy loss (5.2% and 15.7%), pregnancy-induced hypertension (0 and 10%), discordancy (12% and 18. 4%), intrauterine growth restriction (0 and 40%), and gestational diabetes (0% and 6%). However, the rate of all pregnancy complications was lower among second-trimester MFPR patients.


CONCLUSIONS
Selective second-trimester MFPR is associated with favorable perinatal outcome and may facilitate detection of structural and chromosomal anomalies before the procedure and selective reduction of the affected fetus.
Geva
E
E
Lis Maternity Hospital, Tel Aviv Sourasky Medical Center; The Chaim Sheba Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel. gevae@obgyn.ucsf.edu
Fait
G
G
Yovel
I
I
Lerner-Geva
L
L
Yaron
Y
Y
Daniel
Y
Y
Amit
A
A
Lessing
J B
JB
D000328:Adult; D001724:Birth Weight; D015331:Cohort Studies; D016640:Diabetes, Gestational; D005260:Female; D005313:Fetal Death / Q000453:epidemiology; D006801:Humans; D006973:Hypertension; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D011256:Pregnancy Outcome; D018607:Pregnancy Reduction, Multifetal / Q000706:statistics & numerical data; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data; D011296:Prenatal Diagnosis