title: Perinatal outcome after fetal reduction from twin to singleton: to reduce or not to reduce?
abstract: OBJECTIVE
  To determine whether reduction of twin gestation to singleton pregnancy is associated with improved perinatal outcome.
  
  
  METHODS
  A retrospective cohort study.
  
  
  METHODS
  Single tertiary care medical center.
  
  
  METHODS
  A cohort of 63 singleton pregnancies after reduction from dichorionic-diamniotic twins gestation and 62 dichorionic-diamniotic nonreduced twins.
  
  
  METHODS
  Fetal reduction between 11 and 14 weeks of gestation.
  
  
  METHODS
  Obstetric outcome.
  
  
  RESULTS
  The rates of preterm delivery at <34 weeks (1.6% in pregnancies after reduction vs. 11.7% in nonreduced twins) and at <37 weeks of gestation (9.5% vs. 56.7%) were significantly lower in patients whose pregnancies were reduced to singletons. The rates of miscarriage of one twin (0% vs. 4.8%) and early pregnancy loss before 24 weeks of gestation as well as the rates of gestational diabetes (11.1% vs. 10%), hypertensive diseases of pregnancy (6.3% vs. 15%), and intrauterine growth restriction (0% vs. 3.3%) were similar in both groups.
  
  
  CONCLUSIONS
  Fetal reduction of twins to singleton is associated with a lower risk of prematurity and superior perinatal outcome compared with nonreduced twins. Therefore, the option of fetal reduction should be considered in certain cases of twin pregnancies, where the risk for adverse outcome seems exceptionally high.
authors.affiliation: Department of Obstetrics and Gynecology, Sheba Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Hashomer, Israel. Electronic address: jigalh@hotmail.com.
authors.forename: Jigal
authors.initials: J
authors.lastname: Haas
authors.affiliation: Department of Obstetrics and Gynecology, Sheba Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Hashomer, Israel.
authors.forename: Aya
authors.initials: A
authors.lastname: Mohr Sasson
authors.affiliation: Department of Obstetrics and Gynecology, Sheba Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Hashomer, Israel.
authors.forename: Eran
authors.initials: E
authors.lastname: Barzilay
authors.affiliation: Department of Obstetrics and Gynecology, Sheba Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Hashomer, Israel.
authors.forename: Shali
authors.initials: S
authors.lastname: Mazaki Tovi
authors.affiliation: Department of Obstetrics and Gynecology, Sheba Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Hashomer, Israel.
authors.forename: Raoul
authors.initials: R
authors.lastname: Orvieto
authors.affiliation: Department of Obstetrics and Gynecology, Sheba Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Hashomer, Israel.
authors.forename: Boaz
authors.initials: B
authors.lastname: Weisz
authors.affiliation: Department of Obstetrics and Gynecology, Sheba Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Hashomer, Israel.
authors.forename: Shlomo
authors.initials: S
authors.lastname: Lipitz
authors.affiliation: Department of Obstetrics and Gynecology, Sheba Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Hashomer, Israel.
authors.forename: Yoav
authors.initials: Y
authors.lastname: Yinon
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008875:Middle Aged; D018743:Perinatal Care / Q000639:trends*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D018607:Pregnancy Reduction, Multifetal / Q000639:trends*; D059285:Pregnancy, Twin / Q000502:physiology; D047928:Premature Birth / Q000453:epidemiology / Q000517:prevention & control; D012189:Retrospective Studies
keywords: Multifetal pregnancy reduction; fetal reduction; obstetric outcome; twin pregnancies