Contemporary outcomes with the latest 1000 cases of multifetal pregnancy reduction (MPR)

Stone, Joanne; Ferrara, Lauren; Kamrath, Jacqueline; Getrajdman, Joelle; Berkowitz, Richard L.; Moshier, Erin; Eddleman, Keith

doi:10.1016/j.ajog.2008.06.017

Cited by 87 publications

(77 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2,22,23 Rates of perinatal death in our study population were consistent with those in studies that reported a decrease in perinatal mortality after fetal reduction in triplet pregnancy from 11% to 6%, 24,25 with triplet pregnancies reduced to twins doing almost as well as unreduced twin pregnancies. Nevertheless, clinicians counselling women with multifetal pregnancy should be aware of the potential for substantial parental stress resulting from fetal reduction procedures, including negative feelings such as guilt, regret and grief.…”

Section: Discussionsupporting

confidence: 80%

“…2 In addition, the risk of miscarriage and preterm birth does not seem to be influenced by the starting number of fetuses. 23 The ICD-10-CA code used to identify fetal reductions has not been validated, although our numbers are consistent with those from the BC Women's Hospital and Health Centre, where more than 90% of such procedures in the province are performed. Residual confounding may have occurred owing to factors not available in our data sources (e.g., maternal education) or imprecise measurement of factors such as socioeconomic status.…”

Section: Strengths and Limitationssupporting

confidence: 67%

“…7,28 However, even in these studies, the risk of preterm birth and infant morbidity was significantly reduced among the triplet pregnancies reduced to singleton pregnancies. 2,8,23 Also, more recent studies showed that reduction of triplet pregnancy to singleton rather than to twin pregnancy was associated with higher rates of term delivery and improved perinatal outcomes, without a significant difference in fetal loss rates. 8,23,29 The higher rate of adverse perinatal outcomes in twin pregnancies is typically a consequence of the higher incidence of preterm delivery.…”

Section: Discussionmentioning

confidence: 99%

“…2,8,23 Also, more recent studies showed that reduction of triplet pregnancy to singleton rather than to twin pregnancy was associated with higher rates of term delivery and improved perinatal outcomes, without a significant difference in fetal loss rates. 8,23,29 The higher rate of adverse perinatal outcomes in twin pregnancies is typically a consequence of the higher incidence of preterm delivery. 29,30 Clinicians report that practice changes related to fetal reduction in multifetal pregnancy are driven mainly by well-informed patients who are aware of safety and efficacy issues based on Internet publications.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Perinatal outcomes in multifetal pregnancy following fetal reduction

Razaz

Avitan

Ting

et al. 2017

CMAJ

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 80%

Section: Strengths and Limitationssupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Perinatal outcomes in multifetal pregnancy following fetal reduction

Razaz

Avitan

Ting

et al. 2017

CMAJ

View full text Add to dashboard Cite

“…26 It is a simple procedure with minimal risk to the surviving foetuses and is devoid of any risk to the maternal well-being. Multifoetal reduction may significantly reduce the risk of prematurity and low birth weight, and may be associated with reduction in overall pregnancy loss.…”

Section: Resultsmentioning

confidence: 99%

Embryo reduction: our experience

Talwar¹,

Sharma²,

Kharb³

et al. 2011

Medical Journal Armed Forces India

View full text Add to dashboard Cite

This increase in multifoetal pregnancy has been from 1.25% in spontaneous pregnancies to 5-8% with clomiphene induced cycles 1,2 and is nearly 30% in patients using exogenous gonadotrophins for super ovulation for sub-fertility. [3][4][5][6] Various measures have been taken to reduce the incidence of multifoetal gestation by making single embryo transfer the norm. 7,8 Multiple pregnancies being high-risk pregnancies are frequently complicated by preterm delivery, low birth weight, preeclampsia and increased perinatal morbidity and mortality. 9,10 Such patients also require more operative interference and prolonged hospital stay for both the mother and the preterm baby thus mounting hospital expenditures.Multifoetal pregnancy reduction, although a well tried technique for preventing the above complications, is a difficult choice for the couples in anguish, to make or agree upon.11 Two-third of the couples who have to undergo this procedure suffer from acute emotional pain, stress, fear, and 20% have a feeling of guilt and anger.12 Therefore adequate counselling is a must before undertaking this procedure.With this primary aim of preventing the myriad complications associated with multifoetal gestation, a policy was adopted at our centre to reduce the higher order pregnancies to a twin gestation.Multifoetal pregnancy reduction can be carried out both transvaginally and transabdominally under ultrasound guidance after proper patient selection and pre-operative counselling. 9,13 Therefore this study was carried out to assess the efficacy of multifoetal pregnancy reduction by transvaginal route, the procedure exclusively carried out at our centre. MATERIALS AND METHODFour thousand four hundred and ninety nine in-vitro fertilisation (IVF) and 7142 intrauterine insemination (IUI) cycles were carried out at this centre till December 2009 with successful outcome in 1630 IVF cycles and 1421 IUI procedures. Embryo reduction was carried out in 52 cases of triplets or higher order pregnancies.Out of the above, 49 patients had triplet pregnancy, two had quadruplet pregnancies, and one quintuplet pregnancy which resulted from IUI. Multifoetal pregnancy reduction was carried out with aim of having two live foetuses after the procedure. Being IVF pregnancies these were diagnosed very early, at 5-6 weeks of gestation. All the patients were offered luteal support with micronized progesterone. Patient and relatives were counselled and preanaesthetic check-up was carried out. Each patient was informed about the potential risks of the technique and written consent was obtained before the procedure was carried out.

show abstract

Multifetal pregnancy reduction after IVF

Taso

Maaita

2021

Assisted Reproduction Techniques

View full text Add to dashboard Cite

Contemporary outcomes with the latest 1000 cases of multifetal pregnancy reduction (MPR)

Cited by 87 publications

References 11 publications

Perinatal outcomes in multifetal pregnancy following fetal reduction

Perinatal outcomes in multifetal pregnancy following fetal reduction

Embryo reduction: our experience

Multifetal pregnancy reduction after IVF

Contact Info

Product

Resources

About