EFFECTS OF SELECTIVE REDUCTION IN TRIPLET GESTATION - A COMPARATIVE-STUDY OF 80 CASES MANAGED WITH OR WITHOUT THIS PROCEDURE

Objective: To evaluate the effect of selective termination in triplet pregnancies. Design: Comparative, prospective, nonrandomized study. Se tting: All 80 pregnancies were managed in a single tertiary center by the same obstetrical team. Patients: Eighty women with triplet pregnan cies were divided into two groups: group I consisted of 48 women who w ished to continue their pregnancies without reduction; in group II wer e 32 women who choose reduction generally to obtain twins. Interventio ns: Selective terminations were performed after an average term of 9.6 weeks of gestation by transcervical or transabdominal approaches. Mai n Outcome Measurements: The rate of miscarriage and prematurity, fetal growth, perinatal morbidity and mortality, and maternal complications in the two groups. Results: Prematurity was lower in reduced pregnanc ies (95.5% in triplets versus 53.5%), especially between 24 to 32 week s' gestation where prematurity was reduced by half. Birth weight was > 450 g higher in the reduced group. The perinatal mortality rate was lo wer for reduced pregnancies, but this difference was not statistically significant. Five life-threatening maternal complications occurred in triplets, with none in the reduced group. Conclusions: Selective term inations are effective in decreasing the rate of prematurity, improvin g fetal growth, and avoiding maternal complications. The procedure thu s could be used in triplet gestations. The ultimate decision should be taken by the couple who must be well informed of the risks of the pro cedure before deciding.