Transabdominal selective feticide in dichorionic twins: Ten years’ experience at a single center

Kim, Mi Sun; Na, Eun Duc; Kang, Suk Ho; Shin, So Yeon; Lim, Bo Bae; Kim, Hounyoung; Moon, Miri

doi:10.1111/jog.13830

Cited by 6 publications

(13 citation statements)

References 33 publications

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“…In studies of the effect of 2-to-1 reduction on fetal loss, some reported a direct association with timing of the procedure (trend level or significant difference) 17,18,22,23 whereas others found late reduction to be equally safe. [19][20][21]25 Although factors other than indication and timing may affect maternal and fetal outcome in this setting, such as previous PTB, short cervical length, previous conization, and maternal Müllerian anomalies, we were unable to perform a stratified statistical analysis owing to the small sample size of most of the individual studies and the sparsity of the relevant reported data.…”

Section: Discussionmentioning

confidence: 99%

“…Several other trials that did not meet our inclusion criteria supported a possible association between early versus late reduction and rate of PTB, 18,25 whereas others did not. 17,[19][20][21] Recently, Zemet et al 25 compared 172 early elective reductions (11-14 weeks of pregnancy)…”

Section: Discussionmentioning

confidence: 99%

“…After screening the titles and abstracts, the reviewers rejected 2442 studies from the analysis because they reported outcomes of higher-order (i.e., not twin) multifetal pregnancy reduction, they were commentaries, systematic reviews, or meta-analyses, or they were duplicates. Of the 16 studies that remained for full-text review, [7][8][9][10][11][12][13][16][17][18][19][20][21][22][23][24] nine were excluded because there was no control group (i.e., ongoing twin pregnancies), [16][17][18][19][20][21][22][23][24] and one was excluded because an early (before 11 weeks) transvaginal approach was used, 13 a PICOSS exclusion criterion. Finally, six studies met our inclusion criteria [7][8][9][10][11][12] as described in Figure 1.…”

Section: Study Selectionmentioning

confidence: 99%

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Fetal reduction from twin to singleton gestation: A meta‐analysis

Bardin

Gupta

Greenberg

et al. 2021

Intl J Gynecology & Obste

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Twins account for 2%-4% of all births. The major factors contributing to twin pregnancy are advanced maternal age and increased use of assisted reproductive technologies. Geography, ethnicity, decline in fertility, use of oral contraceptives and family history may also play a role. 1 Compared with singleton pregnancy, twin pregnancy is associated with a 2-to 3.5-fold higher risk of maternal hypertensive disorders and hyperglycemia in pregnancy and a 2-to 3-fold higher risk of maternal and perinatal mortality. 2 Preterm birth (PTB), a major complication of multiple gestations, occurs in approximately half of all twin pregnancies, and early PTB (before 32 weeks of pregnancy) in 14% of twin pregnancies. 3 Multifetal pregnancy reduction is a procedure performed to lower the number of fetuses in order to reduce the incidence of adverse outcomes. Although the term elective reduction is often used

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

See 1 more Smart Citation

Fetal reduction from twin to singleton gestation: A meta‐analysis

Bardin

Gupta

Greenberg

et al. 2021

Intl J Gynecology & Obste

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“…Greenberg demonstrated that pregnancy was prolonged for women who underwent reduction in the first trimester (37.3 weeks) compared with the second trimester (36.4 weeks) and third trimester (35.3 weeks) [ 23 ]. One study also found that the birth weight of the foetus was significantly increased when SR was performed at a time point that was earlier than 15 weeks [ 24 ]. Bigelow et al suggested that foetal loss and preterm delivery after SR for twin pregnancies was associated with increasing gestational age at the time of the procedure [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Correlation analysis of adverse outcomes for the selective reduction of twin pregnancies

Gao

Wang

et al. 2022

BMC Pregnancy Childbirth

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Background Due to the extensive development of assisted reproductive technology, the number of twin pregnancies has increased significantly over recent decades. Twin pregnancy is the most representative type of multiple pregnancies and is associated with high infant morbidity and mortality. Perinatal complications of twin pregnancy are also markedly increased compared with those of single pregnancy. Transabdominal selective reduction (SR) is a remedial intervention. This study aimed to research the adverse outcomes of transabdominal selective reduction of twin pregnancy and the correlation between the reduction week and pregnancy outcomes. Objective The purpose of this study was to examine the adverse outcomes of the transabdominal selective reduction of twin pregnancy and the correlation between the reduction week and pregnancy outcomes. Methods A retrospective cohort study of the transabdominal reduction of twin pregnancy was conducted in a single prenatal diagnosis medical centre from September 2012 to October 2020. According to chorionicity, women with twin pregnancies were divided into 2 groups: dichorionic (DC) twin pregnancies and monochorionic (MC) twin pregnancies. Women with DC twin pregnancies underwent potassium chloride reduction, and those with MC twin pregnancies underwent radiofrequency ablation (RFA). The reduction indications included pregnancy complications, foetal abnormalities, and maternal factors. The perinatal outcomes of different chorionic twins after reduction were analysed. Each foetus with an adverse outcome was included. The relative relationship between the reduction weeks and delivery weeks of twins was examined by correlation analysis. Results A total of 161 women were included in this study. A total of 112 women had DC twin pregnancies, and 49 women had MC twin pregnancies. Preterm delivery rates were significantly higher in the MC twin reduction group than in the DC twin reduction group prior to 37 weeks (53.1% vs. 29.5%, P = 0.004). The mean gestational age at delivery of the foetuses in the DC twin group that underwent SR was significantly older than that of those in the MC twin group that underwent SR (36.9 ± 4.0 vs. 33.5 ± 6.6 weeks, P = 0.001). The number of DC twins that underwent SR and were delivered after 37 weeks was obviously greater than that of the MC twins that underwent SR (70.5% vs. 46.9%, P = 0.004). The foetal survival rate was 95.5% in the DC twin reduction group and 77.6% in the MC twin reduction group. If the indication of TTTS was not included, there was no significant difference in the foetal survival rate of the DC and MC twin reduction groups (95.5% vs. 86.2%, P = 0.160). Cotwin death 1 week after reduction was greater in the MC group (6.1% vs. 0%, P = 0.027). Compared to other indications, this finding indicated that a significantly lower proportion of women remained undelivered after selective reduction with the indication of TTTS. There was a significant negative correlation between the reduction weeks and delivery weeks of the two groups (P < 0.01), and the best opportunity for reduction was before 22 weeks of gestation. Conclusion These findings highlighted an obviously negative correlation between the reduction week and delivery week. The transabdominal selective reduction of twin pregnancy should be considered for a lower rate of miscarriage or premature delivery if the reduction week takes place earlier in pregnancy. The rate of preterm delivery was the lowest when transabdominal selective reduction was completed before 22 weeks of gestation. Compared with other RFA indications, a higher rate of premature delivery was shown for MC twins with a reduction indication of TTTS. TTTS with sIUGR might be one of the reasons for the adverse outcomes of reduction for MC twin pregnancy.

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“…An analysis of data on feticide from 44 cases involving dichorionic (DC) twins was undertaken by Kim et al (2019) in South Korea. Two study groups were fairly evenly divided between two indications for feticide given above (Group I: Anomaly, and Group II: Birth History).…”

Section: Selective Feticide In Dichorionic Twinsmentioning

confidence: 99%

The New Sesquizygotic Twins and More: Exotic Twin Types/Twin Research Reviews: Parental Affection and Co-Twins’ Personality; Prenatal Demise in Twin Pregnancies; Heteropaternal Superfecundation; Selective Feticide in Dichorionic Twins/In the News: Identical Twin Oscar Winner; ‘Superfecundated’ Twins with Gay Fathers; Partly Living Apart; Which Twin Committed the Crime?

Segal

2019

Twin Res Hum Genet

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The second recorded case of sesquizygotic (SQZ) twins is summarized. It is suspected that SQZ twins result from the fertilization of an egg by two separate spermatozoa, followed by division of the fertilized ovum. Next, recent studies examining how differences in parental affection affect co-twins’ personality profiles, the prenatal demise of fetuses during twin pregnancy, a forensic case of heteropaternal superfecundation and selective feticide in dichorionic twins are reviewed. Finally, summaries of newsworthy items featuring an identical twin Oscar winner, a case of ‘superfecundated’ twins born to a gay couple, identical twins who try partly living apart and new molecular techniques to distinguish an innocent identical twin from his or her guilty co-twin are presented.

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Transabdominal selective feticide in dichorionic twins: Ten years’ experience at a single center

Cited by 6 publications

References 33 publications

Fetal reduction from twin to singleton gestation: A meta‐analysis

Fetal reduction from twin to singleton gestation: A meta‐analysis

Correlation analysis of adverse outcomes for the selective reduction of twin pregnancies

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