PREGNANCY OUTCOME AFTER MULTIFETAL PREGNANCY REDUCTION TO TWINS COMPARED WITH SPONTANEOUSLY CONCEIVED TWINS

Multifetal pregnancy reduction (MFPR) appears to be an efficacious met hod for improving the perinatal outcome of 'high order' multifetal ges tations, The present study was undertaken to evaluate pregnancy outcom es after MFPR to twins in comparison with spontaneously conceived twin s, In all, 10 patients with quadruplet gestations (group 1) and 30 pat ients with triplet gestations (group 2), who underwent MFPR to twins, were prospectively enrolled. Pregnancy complications, gestational age at delivery, mode of delivery and birthweights were compared with 30 c onsecutive spontaneous twin gestations (group 3) matched by maternal a ge and parity. Mean gestational age at delivery and mean birthweights were significantly lower in group 1, compared with groups 2 and 3 (33. 2, 35.9, 36.9 weeks, and 1843, 2209, 2361 g respectively), The inciden ce of pregnancy complications was significantly higher in group 1 comp ared with group 3, There was also a clear trend of increased incidence of specific pregnancy complications in group 1 compared with groups 2 and 3, especially premature contractions (PMC; 50, 27 and 13% respect ively), and pregnancy-induced hypertension (PIH; 40, 23 and 7% respect ively), In conclusion, the initial number of fetuses before reduction was inversely correlated with gestational age at delivery and birthwei ght, and positively correlated with pregnancy complications. Contrary to previous studies, we found a higher incidence of pregnancy complica tions after MFPR compared with spontaneous twins, especially PMC and P IH.