Obstetric outcome after fetal reduction to singleton pregnancies.
OBJECTIVE
To study the outcome after fetal reduction or selective termination to singleton pregnancies for various indications.


METHODS
Fetal reduction or selective feticide to singleton pregnancies was performed in 80 multiple gestations (congenital malformations, 17 cases; high-risk obstetric conditions, 25 cases; or social/psychological indications, 38 cases).


RESULTS
The overall pregnancy loss rate was 10%; however, pregnancy failure was significantly higher in selective reductions performed for preterm prelabor rupture of membranes (PPROM) (4/8) compared with monochorionic twin and bad obstetric history. Fetal reduction to singletons for psychological reasons resulted in a pregnancy wastage of 5.3% (2/38). Procedures performed at < or =14 weeks showed a significantly lower fetal loss rate (2/61; 3.3%), a higher mean gestational age at delivery (38.3+/-2.2 weeks), and a decreased prematurity rate (p< or =0.001). The number of reduced fetuses, prenatal diagnosis by chorionic villus sampling before the reduction and maternal age did not interfere with pregnancy outcome.


CONCLUSIONS
Fetal reduction to singleton pregnancies has a favorable outcome, especially when performed before 14 weeks of gestation.
De Catte
L
L
Unit of Feto-Maternal Medicine, Department of Obstetrics and Gynecology, University Hospital Vrije Universiteit Brussel, Brussels, Belgium. luc.decatte@az.vub.ac.be
Foulon
W
W
D000022:Abortion, Spontaneous / Q000453:epidemiology; D001724:Birth Weight; D015193:Chorionic Villi Sampling; D002869:Chromosome Aberrations; D000013:Congenital Abnormalities; D005260:Female; D005313:Fetal Death / Q000453:epidemiology; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D008423:Maternal Age; D011189:Potassium Chloride / Q000008:administration & dosage; D011247:Pregnancy; D018607:Pregnancy Reduction, Multifetal; D018566:Pregnancy, High-Risk; D011446:Prospective Studies; D012307:Risk Factors
D011189:Potassium Chloride