Multifetal pregnancy reduction is not associated with an increased risk of intrauterine growth restriction, except for very-high-order multiples

Török, Olga; Lapinski, Robert; Salafia, Carolyn M.; Bernasko, James; Berkowitz, Richard L.

doi:10.1016/s0002-9378(98)70276-5

Cited by 50 publications

(26 citation statements)

References 10 publications

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“…Our results are consistent with a number of other studies (Evans et al, 1988;Evans et al, 1996;Fasouliotis & Schenker, 1997;Selam et al, 1999;Torok et al, 1998;Yaron et al, 1999). For example, a study by Torok et al (1998) compares 441 monitored pregnancies after reduction with 136 pregnancies where reduction was not performed, and it proves that reduction of multi-fetal pregnancy is not related to intra-uterine growth retardation of fetus, nor to shorter length of pregnancy, unless the original number of fetuses is 5 or more. Another study supporting our conclusion is a study by Yaron et al (1999), where they prove that reduction of a triple pregnancy to a twin one reduces the risk of prematurity, while perinatal results do not differ from results of originally twin pregnancies.…”

Section: Discussionsupporting

confidence: 92%

Multi-Fetal Pregnancy Reduction Does Not Influence Perinatal Results in Twin Pregnancies

Jirsová¹,

Mardešić²,

Muller³

et al. 2001

Twin res.

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The objective of this study was to compare perinatal results in multifetal pregnancies where the reduction to twins was performed with non-reduced twin pregnancies. Perinatal results in 99 sets of twins after transabdominal multifetal pregnancy reduction of triple and higher-order multiple pregnancies performed in a single center were compared with a control group consisting of 151 twin pregnancies conceived in the same time period after infertility treatment, which were not a result of reduction. The main outcome measures were length of pregnancies, weight of the newborns, percentage of miscarriages and the mode of the delivery were analyzed. No significant difference could be found at a 5% level of significance regarding the average duration of pregnancy or average weight of the twins. Fisher test on 5% significance level did not ascertain any significant difference in the probability of miscarriage between the group with reduction (5.26%) and the group without reduction (12.84%). At a 5% level of statistical significance, no significant difference in probability of perinatal death of the fetus or delivery of a stillborn fetus was found. The percentage of cesarean sections did not differ significantly in both groups. The analysis of both groups demonstrated that reduction of multifetal pregnancies to twins may not influence perinatal results in comparison to twin pregnancies where reduction was not performed.

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Section: Discussionsupporting

confidence: 92%

Multi-Fetal Pregnancy Reduction Does Not Influence Perinatal Results in Twin Pregnancies

Jirsová¹,

Mardešić²,

Muller³

et al. 2001

Twin res.

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“…The success rates of fetal reduction have improved with increasing experience, a smaller number of fetuses comprising HOMP, and superior equipment. Although the technique of multifetal pregnancy reduction is a very safe procedure (4,5,9), in the current study, the reduced twin group was associated with elevated rates of prematurity. This means that some effects of HOMP exert persistently and are unable to be totally eliminated by selective fetal reduction.…”

Section: Discussionmentioning

confidence: 52%

“…We therefore questioned whether premature delivery was related to the initial number of embryos implanted in the uterus. In a retrospective study, Torok et al (9) investigated the gestational age distribution of twins at the time of birth as a function of the initial number of fetuses. They found that the prematurity rate associated with two, three, four, and five or more fetuses was 61%, 64.8%, 66.9%, and 67.4%, respectively.…”

Section: Discussionmentioning

confidence: 99%

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A comparison of the outcomes between twin and reduced twin pregnancies produced through assisted reproduction

Cheang

Huang

Lee

et al. 2007

Fertility and Sterility

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“…Most of the excess perinatal morbidity and mortality is directly related to preterm birth. The problem of multiple pregnancy is not easily resolved by multifetal reduction, because reduction decreases, but does not eliminate, the risk of fetal growth restriction or loss of the entire pregnancy [5,6].…”

Section: Risks Of Multiple Pregnanciesmentioning

confidence: 99%

What are the risks of the assisted reproductive technologies (ART) and how can they be minimized?

Rebar

2013

Reprod Medicine & Biology

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Although assisted reproductive technologies (ART) have become established procedures performed around the world, there are still many unanswered questions regarding safety. Possible risks associated with infertility and ART include (1) those inherent to pregnancy, delivery, and childhood; (2) those associated with the infertility itself and its causes; and (3) risks iatrogenic to ART. Although there are many potential risks associated with ART, it has become clear that the major risk is multiple pregnancy and its consequences. Major efforts are warranted to reduce the risk of multiple gestations with IVF, but it is also clear that single-embryo transfer is not the solution in all cases. Moreover, several studies have now documented that perinatal outcomes are somewhat poorer in IVF singleton infants than in spontaneously conceived singletons, but it is not clear if this increased risk is due to the ART or the infertility. Concerns about the impact of abnormalities in genomic imprinting persist at this time, as do risks associated with the culture conditions and even our environment. Only time will tell if children born following ART are at any increased risk of developing certain chronic diseases as they age. In any case, the risks to IVF children and mothers are likely to remain higher than those for children and mothers conceived spontaneously without medical assistance. However, since there have been over 5 million births after ART worldwide, and the vast majority of pregnancies and children have been essentially ''normal'', it is obvious that any excess risk must be relatively small. The normality of most pregnancies mandates that extreme care be exercised in making any changes to current practice.

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Multifetal pregnancy reduction is not associated with an increased risk of intrauterine growth restriction, except for very-high-order multiples

Cited by 50 publications

References 10 publications

Multi-Fetal Pregnancy Reduction Does Not Influence Perinatal Results in Twin Pregnancies

Multi-Fetal Pregnancy Reduction Does Not Influence Perinatal Results in Twin Pregnancies

A comparison of the outcomes between twin and reduced twin pregnancies produced through assisted reproduction

What are the risks of the assisted reproductive technologies (ART) and how can they be minimized?

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