Multifetal reduction of triplets to twins compared with non-reduced twins: a meta-analysis

Zipori, Yaniv; Haas, Jigal; Berger, Howard

doi:10.1016/j.rbmo.2017.04.001

Cited by 8 publications

(6 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Importantly, twins reduced to singletons did not increase pregnancy loss at <24 weeks. These findings are consistent with previous studies (26) (27), which suggest that MFPR from twins to singletons has a clear advantage for twin pregnancies. The conclusion can be drawn from previous studies and the present study that MFPR improves the outcomes of triplet or twin pregnancies.…”

Section: Discussionsupporting

confidence: 93%

Fetal Reduction Could Improve but Not Completely Reverse the Pregnancy Outcomes of Multiple Pregnancies: Experience From a Single Center

Zhu

Tang

et al. 2022

Front. Endocrinol.

View full text Add to dashboard Cite

ObjectiveTo investigate the effectiveness and limitations of multifetal pregnancy reduction (MFPR) on the improvement of pregnancy outcomes of triplet or twin pregnancies conceived by in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).MethodsWe performed a cohort study of women undergoing IVF or ICSI from 2002–2016 in reproductive center, women’s hospital, Zhejiang University School of Medicine. The cohort included 502 women who underwent MFPR and 9641 non-reduced women. Pregnancy outcomes were gestational age (GA) at delivery, pregnancy loss, preterm delivery, low birth weight (LBW), very low birth weight (VLBW), and small for gestational age (SGA). Multiple linear regression and logistic regression models were used to compare pregnancy outcomes between groups.ResultsTriplets reduced to singletons had a longer median GA (39.07 vs 37.00, P<0.001), and lower rates of LBW (8.9% vs 53.2%, P<0.001) and SGA (17.8% vs 44.7%, P=0.001) than triplets reduced to twins, with a similar pregnancy loss rate (6.7% vs 6.6%, P=0.701). Twins reduced to singletons had a comparable pregnancy loss rate (4.8% vs. 6.5%, P=0.40), a longer median GA (38.79 vs. 37.00, P<0.001), and lower rates of LBW (13.5% vs. 47.0%, P<0.001) and SGA (13.5% vs. 39.6%, P<0.001) than primary twins. Triplets reduced to twins had higher rates of LBW (53.2% vs. 47.0%, P=0.028) and SGA (44.7% vs. 39.6%, P=0.040) than primary twins, with a similar pregnancy loss rate (6.6% vs. 6.5%, P=0.877). Singletons reduced from triplets/twins had higher rates of preterm delivery (15.8% vs. 7.3%, P<0.001), LBW (12.3% vs. 4.32%, P<0.001), VLBW (2.3% vs. 0.4%, P=0.002), and SGA (14.6% vs.6.6%, P<0.001) than primary singletons, with a comparable pregnancy loss rate (5.3% vs. 5.4%, P=0.671).ConclusionsThis study suggests that the pregnancy loss rate is similar between reduction and non-reduction groups. MFPR improves pregnancy outcomes, including the risk of preterm delivery, LBW, and SGA, but still could not completely reverse the adverse pregnancy outcomes of multiple pregnancies.

show abstract

Section: Discussionsupporting

confidence: 93%

Fetal Reduction Could Improve but Not Completely Reverse the Pregnancy Outcomes of Multiple Pregnancies: Experience From a Single Center

Zhu

Tang

et al. 2022

Front. Endocrinol.

View full text Add to dashboard Cite

show abstract

“…In a meta‐analysis by Zipori et al, a comparable perinatal outcome was found between the FR group and the nonreduced DCDA twin's group in terms of prematurity rate before 28, 32, or 36 weeks, fetal weight, pregnancy loss before 24 weeks, and the development of gestational diabetes and hypertension disorders. The only difference in the analysis was the significantly higher cesarean section rate in the FR group compared to the non‐reduced DCDA twin group 23 . Kim et al compared the results of 59 DCDA twins who had a fetal reduction and 157 DCDA twins who did not.…”

Section: Discussionmentioning

confidence: 99%

The initial number of fetuses in multiple pregnancy before reduction affects perinatal outcomes

Akkuş,

Doğru,

Atcı

et al. 2023

J of Obstet and Gynaecol

View full text Add to dashboard Cite

ObjectiveIn this study, we aimed to evaluate the perinatal outcomes of dichorionic diamniotic (DCDA) twin pregnancies reduced by the fetal reduction (FR) procedure and cases with continuing DCDA twin pregnancies without FR.Materials and MethodsFR performed in a university hospital in the last 10 years was evaluated. Pregnancies reduced to DCDA twin pregnancies by reduction from three or more pregnancies and pregnancies that started with DCDA twins and continued with DCDA twins were compared in terms of perinatal outcomes. In the subgroup analysis, those who were reduced from three‐chorionic three‐amniotic (TCTA) triplets to DCDA twins and those who were reduced to DCDA twin pregnancies from four or more were compared in terms of perinatal outcomes.ResultsA total of 119 pregnant women were included in the study, 36 patients underwent FR, while 83 patients were DCDA twins who did not undergo FR. The groups were similar in terms of preterm delivery (p = 0.370). There was a higher rate of miscarriage (21.4% vs. 0.0%, p = 0.019) in the group that was reduced to DCDA twins from quadruplet and above pregnancies compared to the group that was reduced from TCTA triplets to DCDA twins. The gestational week at birth was lower in the group reduced to DCDA twins from quadruplets and above pregnancies (31.00 ± 4.31 vs. 34.64 ± 2.88, p = 0.019).ConclusionThe study's results show that the perinatal outcomes of multiple pregnancies with and without FR are the same As the number of reduced fetuses increases, the rates of preterm birth and miscarriage also increase.

show abstract

“…Overall rates of pregnancy loss after multifetal reduction procedure are low and comparable to rates of loss with expectant management of a multifetal gestation. [26][27][28] Although preterm labor and pregnancy loss postprocedure are more commonly related to spontaneous rupture of membranes, infection has been described as an uncommon complication of reduction that may be associated with untimely fetal loss. 29 While chorionic villous sampling also carries a rare risk of procedurerelated infection, 30,31 the prolonged time interval from sampling procedure at 14 weeks to clinical symptoms at 17 weeks precludes this possibility in this case.…”

Section: Discussionmentioning

confidence: 99%

Florid Bacillus cereus Infection of the Placenta Associated With Intrauterine Fetal Demise

et al. 2021

View full text Add to dashboard Cite

Bacillus cereus is a gram-positive, rod-shaped bacterium that is commonly implicated in foodborne illness but has also become increasingly recognized as a source of serious non-gastrointestinal infections, including sepsis, meningitis, and pneumonia. Non-gastrointestinal B. cereus infections have been identified in children, especially in neonates; however, there are no previously described cases of fetal demise associated with B. cereus placental infection. We present a case of acute chorioamnionitis-related intrauterine fetal demise of twin A at 17 weeks gestation, noted two days after selective termination of twin B. Histological examination revealed numerous gram-positive bacilli in placental tissue, as well as fetal vasculature, in the setting of severe acute necrotizing chorioamnionitis and subchorionitis, intervillous abscesses, acute villitis, and peripheral acute funisitis. Cultures of maternal blood and placental tissue both yielded growth of B. cereus. This case underscores the importance of B. cereus as a human pathogen, and specifically demonstrates its potential as an agent of severe intraamniotic and placental infection with poor outcomes for the fetus.

show abstract

Multifetal reduction of triplets to twins compared with non-reduced twins: a meta-analysis

Cited by 8 publications

References 39 publications

Fetal Reduction Could Improve but Not Completely Reverse the Pregnancy Outcomes of Multiple Pregnancies: Experience From a Single Center

Fetal Reduction Could Improve but Not Completely Reverse the Pregnancy Outcomes of Multiple Pregnancies: Experience From a Single Center

The initial number of fetuses in multiple pregnancy before reduction affects perinatal outcomes

Florid Bacillus cereus Infection of the Placenta Associated With Intrauterine Fetal Demise

Contact Info

Product

Resources

About