What is selective termination of pregnancy?

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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