Authors:
Lipitz S. Yaron Y. Shalev J. Achiron R. Zolti M. Mashiach S.
Institution:
Department of Obstetrics/Gynecology, Chaim Sheba Medical Center,Tel Hashomer 52621; Israel.
Title:
Improved results in multifetal pregnancy reduction: A report of 72 cases (1994-358).
Source:
Fertility and Sterility. Vol 61(1) (pp9-61), 1994.
Abstract:
Objectives:
To evaluate pregnancy outcome after either transabdominal or transvaginal multifetal pregnancy reduction.
Design:
A study of 72 consecutive multifetal pregnancy reductions.
Setting:
Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center Tel Hashomer, Israel.
Patients:
Seventy-two patients with multifetal pregnancies: 2 twins, 27 triplets, 26 quadruplets, 10 quintuplets, 3 sextuplets, 1 septuplet, 2 nontuplets, and one pregnancy with 12 fetuses.
Intervention:
Multifetal pregnancy reduction was performed at 9 to 13 weeks' gestation by either transabdominal or transvaginal potassium chloride injection.
Settings, Design and Main Outcome Measures:
Early and late complications related to the procedure, outcome of pregnancy, and comparison of two periods.
Results:
Procedures performed between 1984 and 1989 (36 patients) were associated with a 33.3% pregnancy loss, whereas those performed between 1990 and 1992 (36 patients) were associated with no pregnancy loss. Of the 17 patients with quintuplets or more, 10 (59%) delivered live and healthy newborns. No difference was found when comparing the transabdominal and the transvaginal approaches.
Conclusions:
Both transvaginal and transabdominal approaches are comparable. There is a remarkable decrease in pregnancy loss with experience.
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