Perinatal outcomes in multifetal pregnancy following fetal reduction

Razaz, Neda; Avitan, Tehila; Ting, Joseph; Pressey, Tracy; Joseph, K.S.

doi:10.1503/cmaj.160722

Cited by 23 publications

(23 citation statements)

References 31 publications

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“…Compared with singleton and twin pregnancies, HOMPs are associated with a higher risk of maternal-perinatal and long-term complications [9][10][11][12] and increased hospital costs [13]. Compared with singleton and twin pregnancies, triplet pregnancies are at a higher risk of miscarriage and preterm birth [5,[14][15][16][17]. To reduce the risks associated with triplet pregnancies and HOMPs [18,19], multifoetal pregnancy reduction (MFPR) has been performed in recent years, and several methods have been described [20,21].…”

Section: Introductionmentioning

confidence: 99%

Pregnancy outcomes of dichorionic triamniotic triplet pregnancies after in vitro fertilization-embryo transfer: multifoetal pregnancy reduction versus expectant management

Cai

Ouyang

Gong

et al. 2020

BMC Pregnancy Childbirth

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Background: Trichorionic triplet pregnancy reduction to twin pregnancy is associated with a lower risk of preterm delivery but not with a lower risk of miscarriage. However, data on dichorionic triamniotic (DCTA) triplet pregnancy outcomes are lacking. This study aimed to compare the pregnancy outcomes of DCTA triplets conceived via in vitro fertilization-embryo transfer (IVF-ET) managed expectantly or reduced to a monochorionic (MC) singleton or monochorionic diamniotic (MCDA) twins at 11-13 + 6 gestational weeks. Methods: Two hundred ninety-eight patients with DCTA triplets conceived via IVF-ET between 2012 and 2016 were retrospectively analysed. DCTA triplets with three live foetuses were reduced to a MC singleton (group A) or MCDA twins (group B) or underwent expectant management (group C). Each multifoetal pregnancy reduction (MFPR) was performed at 11-13 + 6 gestational weeks. Pregnancy outcomes in the 3 groups were compared. Results: Eighty-four DCTA pregnancies were reduced to MC singleton pregnancies, 149 were reduced to MCDA pregnancies, and 65 were managed expectantly. There were no significant differences among groups A, B, and C in miscarriage rate (8.3 vs. 7.4 vs. 10.8%, respectively) and live birth rate (90.5 vs. 85.2 vs. 83.1%, respectively) (P > 0.05). Group A had significantly lower rates of preterm birth (8.3 vs. 84.6%; odds ratio (OR) 0.017, 95% confidence interval (CI) 0.006-0.046) and low birth weight (LBW; 9.2 vs. 93.2%; OR 0.007, 95% CI 0.003-0.020) than group C (P < 0.001). Group B had significantly lower preterm birth (47.0 vs. 84.6%; OR 0.161, 95% CI 0.076-0.340) and LBW rates (58.7 vs. 93.2%; OR 0.103, 95% CI 0.053-0.200) than group C (P < 0.001). Group A had significantly lower preterm birth (8.3 vs. 47.0%; OR 0.103, 95% CI 0.044-0.237; P < 0.001), LBW (9.2 vs. 58.7%; OR 0.071, 95% CI 0.032-0.162; P < 0.001) and perinatal death rates (1.3 vs. 9.1%; OR 0.132, 95% CI 0.018-0.991; P = 0.021) than group B.

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Section: Introductionmentioning

confidence: 99%

Pregnancy outcomes of dichorionic triamniotic triplet pregnancies after in vitro fertilization-embryo transfer: multifoetal pregnancy reduction versus expectant management

Cai

Ouyang

Gong

et al. 2020

BMC Pregnancy Childbirth

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“…Multifetal pregnancy has been linked to preterm delivery, which is associated with neonatal mortality and morbidity. The number of multifetal pregnancies continues to increase due to increase in maternal age and ART. Many investigations into MPR‐associated fetal loss have focused on the individual procedures or MPR timing.…”

Section: Discussionmentioning

confidence: 99%

Procedural and obstetric outcomes after embryo reduction vs fetal reduction in multifetal pregnancy

Kim

Choi

Kwon

et al. 2019

Ultrasound in Obstet & Gyne

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The FR procedure is overall a better and safer approach to reducing morbidity and mortality in MPs. Spontaneous demise of one fetus may occur after ER, and FR has advantages because chorionic villus sampling and ultrasound screening for nuchal translucency and anatomical defects can be conducted before the procedure. The ER approach is still reasonable when a patient's religious or other ethical concerns are of primary importance.

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“…It was not the first time that, in the framework of assisted reproduction techniques, rate ratios have been calculated instead of risk ratios. Such a use is due to the fact that, implicitly, a cycle of ART is considered a unit of time, thus leading to the consideration of the proportion of failure or success as a rate [ 1 , 2 ]. In such a situation, rate ratios and risk ratios are equal.…”

Section: Dear Editormentioning

confidence: 99%