A 3 YEAR, PROSPECTIVELY-DESIGNED STUDY OF LATE SELECTIVE MULTIFETAL PREGNANCY REDUCTION

The aim of our study was to evaluate the pregnancy outcomes of late se lective multifetal reduction (MFPR). We performed a 3 year, prospectiv ely-designed study in which 28 patients underwent MFPR at a mean gesta tional age of 20.2 +/- 3.9 weeks (range 14-29 weeks). The indications for MFPR included: multiple gestation (greater than or equal to 3) (57 %), structural anomaly (29%), and chromosomal abnormality (14%). The p rocedure was performed using ultrasonographically-guided intracardiac injection of potassium chloride. The mean gestational age at delivery was 36.6 +/- 2.2 weeks (range 31-30 weeks). Nine patients (32%) delive red before 36 weeks of gestation. The mean birth weight was 2370 +/- 6 14 g (range 1510-3250 g). Discordancy was evident in four twins (14%), and intrauterine growth retardation in four pregnancies. One case (3. 5%) presented with oligohydramnios, and one with pregnancy-induced hyp ertension. One case of late abortion due to passive cervical dilatatio n 4 weeks after the MFPR was observed. Procedure-related amnionitis fo llowed by late abortion occurred in one case. A total of 57 % of the p atients delivered vaginally and 43% delivered by Caesarean section. We concluded that late selective MFPR is associated with favourable peri natal outcome. Late MFPR may facilitate the detection of structural an d chromosomal anomalies prior to the procedure, and the accomplishment of selective reduction of the affected fetus.