Outcomes of Multifetal Reduction: A Hospital-Based Study

Dey, Madhusudan; Saraswat, Monica

doi:10.1007/s13224-017-1024-1

Cited by 4 publications

(6 citation statements)

References 12 publications

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“…11 High order pregnancies sometimes carries a higher risk of prenatal outcomes, significant complications of prematurity and most common is preterm labour. 12 The data of this study showed that the outcome of triplet pregnancies reduced to twins differ substantially from the non-reduced group. The information regarding the outcome of twin pregnancies after reduction is based on limited subjects.…”

Section: Discussionmentioning

confidence: 64%

Clinical study comparing outcome of post in vitro fertilisation triplet pregnancy reduced to twins versus non reduced in vitro fertilisation triplet pregnancies

Sharma

Bhatt

Kapur

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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Background: There has been an upsurge in the number of multiple pregnancies with its attributability to increasing use of artificial reproductive techniques. To study clinical outcome of post IVF triplet pregnancy reduced to twin pregnancies compared to those without triplet reduction.Methods: Hospital designed comparative study. 31 subjects were studied for comparative study design with triplets obtained after infertility treatment (assisted post-IVF). Out of 31, 15 subjects were expectantly managed who refused reduction while 16 subjects chose reduction to twins. Outcomes like prematurity, complications in neonate, birth weight discordance, neonatal mortality and maternal complications were studied.Results: The fetal (triplet) reduction group was associated with significant (p<0.002) higher neonatal birth weight as compared to non-reduced group. The fetal reduction group had significantly lower incidence of prematurity and neonatal complications like hyperbilirubinemia, respiratory distress syndrome and neonatal sepsis. The maternal complications were also higher in nonreduced in terms of PPROM, gestational hypertension, gestational diabetes mellitus, intrahepatic cholestasis of pregnancy and gestational hypertension.Conclusions: It is indicated that the reduction of triplet to twins is effective considering more complications with non-reduced group and hence reduction improves favorable pregnancy outcomes.

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Section: Discussionmentioning

confidence: 64%

Clinical study comparing outcome of post in vitro fertilisation triplet pregnancy reduced to twins versus non reduced in vitro fertilisation triplet pregnancies

Sharma

Bhatt

Kapur

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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show abstract

“…8 In our case, patient was counselled about the risk of higher spontaneous abortions and preterm labour rates in multiple pregnancies and was offered the option of fetal reduction. 9 The risks of procedure was explained to the patient and informed consent was obtained. 10 Haiyan et al, reported a case of triplet pregnancy, during first trimester management options included fetal reduction of two twins by fetal intracardiac injection of KCl by ultrasound guided trans abdominal procedure.…”

Section: Discussionmentioning

confidence: 99%

Successful pregnancy outcome after fetal reduction in a woman with quadruplet pregnancy to twin pregnancy

Krishnamoorthy¹,

Amutha²

2020

IJOGR

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First trimester transvaginal embryo reduction is an effective alternative for the management of multifetal pregnancy in assisted reproduction and is done by performing an intracardiac embryo puncture until a systole is verified.A 32-year-old G2 A1 conceived through in vitro fertilization (IVF) at 10 weeks of gestation. Ultrasonography confirmed quadruplet pregnancy with viability of all four fetuses with minimal sub chorionic hemorrhage. The couple was counselled about all potential complications and were counselled to undergo fetal reduction of quadruplets to twins. She underwent fetal reduction and pregnancy was uneventful in first and second trimesters with regular antenatal check-ups. In third trimester the woman with 35 weeks of gestation with twin breech presented with premature preterm rupture of membranes (PPROM), delivered by emergency lower section caesarean section (LSCS) with first twin as breech and second twin as vertex. First twin was delivered with birth weight 1.75 kg and second twin with birth weight 1.75 kg.

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“…Notably, using KCl becomes more imperative with advancing gestational age, mainly when the goal is to terminate larger fetuses. Significantly, this method is associated with favorable pregnancy outcomes when applied for fetal reduction in multifetal pregnancies [ 41 ]. Moreover, a compelling case report contributes to the growing body of evidence by detailing the successful non-surgical management of a heterotopic abdominal pregnancy.…”

Section: Reviewmentioning

confidence: 99%

“…A range of methods exists for fetal reduction, encompassing transabdominal, transcervical, or transvaginal approaches, along with chemical, thermal, radiofrequency, or laser techniques, contingent upon factors such as chorionicity [ 39 ]. MFPR is designed to decrease higher-order pregnancies, enhancing perinatal outcomes [ 41 ]. In the context of unruptured HP, the suggestion to use KCl infusion for fetal reduction has been made.…”

Section: Reviewmentioning

confidence: 99%

“…The acceptability of these options for the couple is contingent upon their social background [ 47 ]. Some advocate delaying fetal reduction until the late first trimester, anticipating a natural reduction of the fetus and allowing for anomaly detection [ 41 ]. Distinct from MFPR, selective reduction involves choosing fetuses based on health status [ 30 ].…”

Section: Reviewmentioning

confidence: 99%

See 1 more Smart Citation

Fetal Reduction by Potassium Chloride Infusion in Unruptured Heterotopic Pregnancy: A Comprehensive Review

Agrawal,

Reddy,

Patel

et al. 2024

Cureus

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This comprehensive review explores the practice of fetal reduction through potassium chloride infusion in unruptured heterotopic pregnancies. Heterotopic pregnancies, characterized by the simultaneous occurrence of intrauterine and extrauterine gestations, present unique challenges in reproductive medicine. The review defines fetal reduction and underscores its significance in mitigating risks associated with heterotopic pregnancies, including the threat of rupture, maternal morbidity, and adverse outcomes. The analysis encompasses the background, methods, efficacy, ethical considerations, and future directions related to the procedure. Findings highlight the efficacy and safety of potassium chloride infusion, emphasizing the importance of proper patient selection and counseling. Implications for clinical practice underscore the procedure's viability in specific cases where the benefits outweigh the associated risks. The review concludes with recommendations for future studies, encouraging further research on procedural techniques, alternative methods, and the psychosocial impact on patients. This work is a foundation for advancing the management of unruptured heterotopic pregnancies, providing insights for clinicians and researchers to improve clinical outcomes and patient care.

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Outcomes of Multifetal Reduction: A Hospital-Based Study

Abstract: Favorable pregnancy outcomes can be achieved after multifetal reductions during first trimester in higher-order multiples, but the procedure is not totally safe.

Cited by 4 publications

References 12 publications

Clinical study comparing outcome of post in vitro fertilisation triplet pregnancy reduced to twins versus non reduced in vitro fertilisation triplet pregnancies

Clinical study comparing outcome of post in vitro fertilisation triplet pregnancy reduced to twins versus non reduced in vitro fertilisation triplet pregnancies

Successful pregnancy outcome after fetal reduction in a woman with quadruplet pregnancy to twin pregnancy

Fetal Reduction by Potassium Chloride Infusion in Unruptured Heterotopic Pregnancy: A Comprehensive Review

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