title: Trichorionic and dichorionic triplet pregnancies at 10-14 weeks: outcome after embryo reduction compared to expectant management.
abstract: OBJECTIVE
  To compare the outcome of trichorionic triplet (TCT) and dichorionic triplet (DCT) pregnancies managed expectantly and those with embryo reduction (ER) at 10-14 weeks to twins or singletons.
  
  
  METHODS
  This was a retrospective study of triplet pregnancies with 3 live fetuses managed expectantly or by ER. Data were combined with the results of previous studies that used similar entry criteria and outcome measures. The management options were compared for rates of miscarriage and preterm birth <33 weeks.
  
  
  RESULTS
  In TCTs managed expectantly (n = 358), the rates of miscarriage and preterm birth were 3.1 and 35.1%. Compared to the expectantly managed TCTs, the rate of miscarriage was higher and preterm birth lower in TCTs with ER to 2 fetuses (n = 833, 7.3 and 13.1%, respectively) and TCTs with ER to 1 fetus (n = 78, 11.5 and 8.7%). In DCTs managed expectantly (n = 136), the rates of miscarriage and preterm birth were 8.8 and 46.0%. In DCTs with ER to 2 fetuses (n = 15) or ER to 1 fetus (n = 42), there was a non-significant increase in miscarriage (13.3 and 16.7%, respectively) and decrease in preterm birth (23.1 and 8%, respectively).
  
  
  CONCLUSIONS
  In TCT and DCT pregnancies, ER increases the rate of miscarriage but reduces the rate of preterm birth.
authors.affiliation: Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK.
authors.forename: P
authors.initials: P
authors.lastname: Chaveeva
authors.forename: P
authors.initials: P
authors.lastname: Kosinski
authors.forename: D
authors.initials: D
authors.lastname: Puglia
authors.forename: L C
authors.initials: LC
authors.lastname: Poon
authors.forename: K H
authors.initials: KH
authors.lastname: Nicolaides
mesh_terms: D000022:Abortion, Spontaneous / Q000209:etiology; D000293:Adolescent; D000328:Adult; D002823:Chorion / Q000033:anatomy & histology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome; D018607:Pregnancy Reduction, Multifetal / Q000009:adverse effects / Q000379:methods; D059286:Pregnancy, Triplet; D047928:Premature Birth / Q000209:etiology / Q000517:prevention & control; D011295:Prenatal Care; D012189:Retrospective Studies; D012307:Risk Factors; D014310:Triplets; D055815:Young Adult