THE EFFECTS OF MULTIPLE GESTATION AND SELECTIVE REDUCTION ON FETAL-OUTCOME

A group of 32 women with at least 3 or more viable fetuses by sonograp hy at approximately 8 weeks gestation were given the option of selecti ve reduction. They were advised that this was a relatively new procedu re but heretofore in a small series was not associated with a signific ant increase in fetal demise. Only 7 of 32 women chose this option. si x of these 7 had triplets reduced to twins, 1 woman had quadruplets re duced to twins. Thirteen of 14 viable babies were successfully deliver ed at a mean of 36.8 weeks gestation; 2 of 7 (28.6%) delivered before 37 weeks. In contrast, 7 of 25 (24%) not having reduction lost all bab ies (6 triplets, 1 quadruplet). Four other women lost at least 1 of th eir gestations (total of 5 babies). Pre-term deliveries (< 37 weeks) o ccurred in 16 of 18 (88.8%) patients delivering at least 1 live baby, with a mean of 33.7 weeks gestation. Thus the high rate of total fetal loss and prematurity for multiple gestation and the low pregnancy was tage and pre-term delivery rate following selective reduction might ma ke the latter a reasonable therapeutic option to patients interested i n having the best chance of delivering healthy viable babies.