title: Spontaneous fetal reduction and early pregnancy complications in multiple pregnancies following in vitro fertilization.
abstract: OBJECTIVE
  To determine the incidence of spontaneous pregnancy reduction and early pregnancy complications among multiple pregnancies conceived via in vitro fertilization (IVF).
  
  
  METHODS
  Spontaneous pregnancy reduction was assessed among multiple pregnancies conceived after IVF treatment in a private assisted reproduction center in Lagos, Nigeria, between January 2008, and June 2011. The pregnancies were diagnosed at 6-8 weeks of gestation by ultrasound scan, which was repeated at 11-14 weeks to determine the incidence of spontaneous reduction.
  
  
  RESULTS
  The incidence of multiple pregnancies was 35.2%. There were 11 (20.0%) twin, 6 triplet (10.5%), and 2 quintuplet (3.6%) pregnancies. Spontaneous reduction occurred in 9 (47.7%) of these pregnancies, including 15.8% of twins, 21% of triplets, and 10.5% of quintuplets. Spontaneous reduction was significant among triplets and quintuplets (P<0.05). Six women (31.5%) older than 36 years had spontaneous reduction (P<0.05). Vaginal bleeding occurred in 3 (15.5%) women, 2 (66.7%) of whom had spontaneous abortion. In all instances of monochorionic placentation, spontaneous reduction resulted in spontaneous abortion.
  
  
  CONCLUSIONS
  The incidence of spontaneous reduction among multiple pregnancies conceived after IVF was high. Vaginal bleeding was a warning sign of eventual abortion. Early pregnancy complications were fewer among pregnancies with dichorionic and trichorionic placentation.
authors: Fetal Medicine Unit, Department of Obstetrics and Gynecology, Lagos State University Teaching Hospital, Lagos, Nigeria. oloyedeoao@yahoo.com
authors: Olufemi A
authors: OA
authors: Oloyede
authors: Faye
authors: F
authors: Iketubosin
authors: Kehinde
authors: K
authors: Bamgbopa
mesh_terms: D000022:Abortion, Spontaneous / Q000000981:diagnostic imaging / Q000453:epidemiology; D000328:Adult; D002823:Chorion / Q000000981:diagnostic imaging; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D018607:Pregnancy Reduction, Multifetal / Q000706:statistics & numerical data*; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data*; D015995:Prevalence; D011811:Quintuplets / Q000706:statistics & numerical data; D014310:Triplets / Q000706:statistics & numerical data; D014427:Twins / Q000706:statistics & numerical data; D016216:Ultrasonography, Prenatal / Q000379:methods / Q000706:statistics & numerical data; D014592:Uterine Hemorrhage / Q000453:epidemiology