MULTIFETAL PREGNANCY REDUCTION - IS IT ALWAYS JUSTIFIED

In the present study we summarized the world literature on first trime ster multifetal pregnancy reduction between 1985 and 1992 and added ou r own experience. Our aim was to reach a comprehensive view on the sur vival rate of reduced high multifetal pregancies, as the data in vario us studies are somewhat confusing, possibly as a result of the small n umber of cases. The data so gathered were classified by the number of fetuses. Of 94 triplet pregnancies reduced to twins 91.6% survived. Of 108 quadruplet pregnancies reduced to twins 92.6% survived. Of 40 qui ntuplet pregnancies 72.5% survived, and of 93 septuplets or more 87.1% survived. The outcome of pregnancies reduced to triplets did not diff er from the outcome of pregnancies reduced to twins, with a survival r ate of 85.7 and 72.5%, respectively. In our opinion, in view of the in fertility history of many of these patients, the risk of pregnancy los s, the high survival rate of triplets and fetal reduction in triplet p regnancies in this group of patients may be unjustified. Accordingly, our policy in cases where the patients demand or when reduction is don e early in pregnancy to reduce the triplets.