Adverse outcome following selective termination of presenting twin <i>vs</i> non‐presenting twin

Miremberg, Hadas; Rosen, Haim; Weisz, Boaz; Tirosh, Dan; Hershkovitz, R.; Stern, Shira; Porat, Shlomo; Beloshevski, B.; Melcer, Yaakov; Goldberg, Yael; Yonai, N. Boms; Awawdeh, M.; Leibovitz, Z.; Shalev, Josef; Gindes, L.

doi:10.1002/uog.26170

Cited by 4 publications

(2 citation statements)

References 19 publications

(24 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Multiple studies have provided evidence on the impact of the position of the reduced fetus on pregnancy outcomes, indicating that reduction of the presenting fetus heightens the likelihood of miscarriage. 21,22 In our investigation, although statistical significance was not attained, a trend towards a higher rate of miscarriage was observed when the presenting fetus was reduced. This finding holds potential clinical implications, underscoring the necessity to consider the position of the reduced fetus when performing the procedures.…”

Section: Discussioncontrasting

confidence: 68%

Outcomes of fetal reduction versus expectant management in dichorionic triamniotic triplets

Meng,

Huang,

Yuan

et al. 2023

Prenatal Diagnosis

View full text Add to dashboard Cite

ObjectiveTo compare the outcomes of dichorionic triamniotic (DCTA) triplets who underwent fetal reduction (FR) to singletons or twins with those managed expectantly.MethodsWe conducted a retrospective study of DCTA triplets with three living fetuses at 11–14 weeks over a 7‐year period. Pregnancy outcomes were compared following different management strategies.ResultsOf 108 included patients, 22 underwent expectant management (EM), 28 were reduced to dichorionic diamniotic twins, and 58 to singletons. The median gestational age at birth for EM, FR to twins, and singletons was 33.1 weeks, 37.0 weeks, and 38.6 weeks, respectively (P < 0.001). Prematurity before 37 and 34 weeks was less common following FR to singletons and twins than in ongoing triplets (18.9%, 46.2% and 90.5%, P < 0.001; 13.2%, 26.9% and 57.1%, P < 0.001). Neonatal birth weight was higher in triplets reduced to singletons and twins compared with EM cases (3140g, 2315g, and 1860g, P < 0.001). However, rates of miscarriage, pregnancies with ≥1 survivor, maternal complications, and adverse neonatal outcomes were comparable among the three groups.ConclusionsIn our experience, FR in DCTA triplets could reduce prematurity risk compared to EM, but it confers no survival advantage. Fetal reduction to singletons may result in more favorable outcomes than those reduced to dichorionic twins.

show abstract

Section: Discussioncontrasting

confidence: 68%

Outcomes of fetal reduction versus expectant management in dichorionic triamniotic triplets

Meng,

Huang,

Yuan

et al. 2023

Prenatal Diagnosis

View full text Add to dashboard Cite

show abstract

“…Moreover, recent studies 26,27 report a very low rate of PPROM after amniocentesis, which precludes the prospective study of the risk of PPROM according to the entry-site location. A recent study showed that, during selective termination in twin pregnancy, the rate of early complications was higher when the presenting twin is terminated, but the gestational age at selective termination was earlier compared with that at FETO 28 .…”

Section: Findings In the Context Of What Is Knownmentioning

confidence: 99%

Effect of cannula insertion site during fetal endoscopic tracheal occlusion for congenital diaphragmatic hernia on preterm prelabor rupture of membranes

Cordier,

Badr,

Basurto

et al. 2024

Ultrasound in Obstet & Gyne

View full text Add to dashboard Cite

ObjectiveFew fetal malformations benefit from in utero surgery. One of the major drawbacks of fetal surgery is preterm premature rupture of membranes (PPROM). Morbidity associated with congenital diaphragmatic hernia (CDH) is primarily respiratory but also gastrointestinal and induced prematurity are likely to worsens those complications. To assess whether or not the cannula insertion site on the maternal abdomen during fetoscopic endoluminal tracheal occlusion (FETO) was associated with PPROM before balloon removal.MethodsThis multicenter retrospective study was conducted on consecutive pregnancies with isolated left‐ or right‐sided CDH fetuses who underwent FETO in 4 centers between January 2009 and January 2021. The insertion site for balloon insertion was categorized as above or below the umbilicus. One propensity score was analyzed in both groups: entry above the umbilicus and entry below, to calculate an average treatment effect (ATE) by inverse probability of treatment weighting (IPTW). Afterwards, one logistic regression and one Cox proportional hazard regression that included the ATE weights were performed to examine the effect size of entry point on the frequency and timing of PPROM prior to the balloon removal procedure.ResultsA total of 294 patients were included. Mean gestational age (GA) at PPROM was 33.50±2.01 weeks of gestation (WG) and the mean rate of PPROM was 25.8% (76/294). GA at FETO was later in the “below umbilicus” group (29.0±1.25 WG vs 29.47±1.29 WG, p=0.002) and the duration of FETO was longer in the “above umbilicus” group (14.49 min [interquartile range‐IQR: 8.00‐21.00] vs 11.00 min [IQR: 7.00‐14.49], p=0.002). After balancing for possible confounding factors, entry point below the umbilicus did not increase the risk of PPROM (adjusted OR: 1.56, 95%CI: [0.89‐2.74], p=0.120) and had no effect on the time point at membrane rupture (adjusted HR: 1.56, 95% CI: [0.95‐2.55], p=0.080).ConclusionThere was no evidence that uterine entry site was correlated with the risk of PPROM before balloon removal.This article is protected by copyright. All rights reserved.

show abstract

Perinatal outcomes between immediate vs deferred selective termination in dichorionic twin pregnancies with fetal congenital anomalies: a French multicenter study

Soussan,

Egloff,

Peyronnet

et al. 2024

American Journal of Obstetrics & Gynecology MFM

View full text Add to dashboard Cite

Adverse outcome following selective termination of presenting twin vs non‐presenting twin

Cited by 4 publications

References 19 publications

Outcomes of fetal reduction versus expectant management in dichorionic triamniotic triplets

Outcomes of fetal reduction versus expectant management in dichorionic triamniotic triplets

Effect of cannula insertion site during fetal endoscopic tracheal occlusion for congenital diaphragmatic hernia on preterm prelabor rupture of membranes

Perinatal outcomes between immediate vs deferred selective termination in dichorionic twin pregnancies with fetal congenital anomalies: a French multicenter study

Contact Info

Product

Resources

About