IMPROVED RESULTS IN MULTIFETAL PREGNANCY REDUCTION - A REPORT OF 72 CASES

Objective: To evaluate pregnancy outcome after either transabdominal o r transvaginal multifetal pregnancy reduction. Design: A study of 72 c onsecutive multifetal pregnancy reductions. Setting: Department of Obs tetrics and Gynecology, The Chaim Sheba Medical Center Tel Hashomer, I srael. Patients: Seventy-two patients with multifetal pregnancies: 2 t wins, 27 triplets, 26 quadruplets, 10 quintuplets, 3 sextuplets, 1 sep tuplet, 2 nontuplets, and one pregnancy with 12 fetuses. Intervention: Multifetal pregnancy reduction was performed at 9 to 13 weeks' gestat ion by either transabdominal or transvaginal potassium chloride inject ion. Main Outcome Measures: Early and late complications related to th e procedure, outcome of pregnancy, and comparison of two periods. Resu lts: Procedures performed between 1984 and 1989 (36 patients) were ass ociated with a 33.3% pregnancy loss, whereas those performed between 1 990 and 1992 (36 patients) were associated with no pregnancy loss. Of the Iii patients with quintuplets or more, 10 (59%) delivered live and healthy newborns. No difference was found when comparing the transabd ominal and the transvaginal approaches. Conclusions: Both transvaginal and transabdominal approaches are comparable. There is a remarkable d ecrease in pregnancy loss with experience.