S. Lipitz et al., PREGNANCY OUTCOME AFTER EARLY AMNIOTIC-FLUID LEAKAGE AFTER TRANSABDOMINAL MULTIFETAL REDUCTION, Fertility and sterility, 65(5), 1996, pp. 1055-1058
Objective: To assess the importance of amniotic fluid leakage in the e
arly period (<14 days) after the fetal reduction procedure. Design: Pr
ospective clinical study. Setting: Pregnant women who underwent fetal
recuction to twins in an academic, tertiary perinatal department. Pati
ents: Sixty triplet and 31 quadruplet pregnancies were identified befo
re the ninth postmenstrual week of gestation. All patients underwent t
ransabdominal multifetal pregnancy reduction to twins at 10 to 12 week
s of gestation. Early postprocedure premature rupture of membranes was
defined as rupture of membranes of the sac on which the multifetal pr
egnancy reduction was performed within 14 days of the procedure. Inter
ventions: Transabdominal multifetal pregnancy reduction from triplets
and quadruplets to twins. Main Outcome Measure: Amniotic fluid leakage
in the early period after fetal reduction. Results: Early FROM occurr
ed in eight (13.3%) patients from the triplets group and in six (19.3%
) patients in the quadruplet group. Three of 60 (5.0%) patients from t
he triplet group and 1 of 31 (3.2%) patients from the quadruplet group
miscarried before 24 weeks gestation. However, none of these patients
had had PROM during the early period after the procedure. Early FROM
did not influence the incidence of premature contractions or delivery
and the outcome of the liveborn infants. Two patients had a loss of on
e twin within 2 weeks from the reduction procedure, and 59% (99/169) o
f those who completed 24 gestational weeks delivered between 25 and 37
weeks. Conclusion: The presence of amniotic fluid leakage in the peri
od close to the multifetal reduction procedure, although alarming, is
not ominous for the remaining fetuses. We see no reason for any interv
ention in these patients.