E. Geva et al., Second-trimester multifetal pregnancy reduction facilitates prenatal diagnosis before the procedure, FERT STERIL, 73(3), 2000, pp. 505-508
Objective: To evaluate the pregnancy outcome of selective second-trimester
multifetal pregnancy reduction (MFPR) compared to first-trimester MFPR.
Design: Cohort analysis.
Setting: In Vitro Fertilization Unit, Tel Aviv Sourasky Medical Center, Tel
Aviv, Israel.
Patient(s): The study groups comprised 38 and 70 patients who underwent sel
ective second-trimester MFPR (group 1) and first-trimester MFPR (group 2) a
. mean gestational ages of 19.7 +/- 3.3 weeks and 11.7 +/- 0.7 weeks, respe
ctively.
Intervention(s): Ultrasenographically guided intracardiac injection of pota
ssium chloride (KCI) solution.
Main Outcome Measure(s): Pregnancy outcome and obstetric complications.
Result(s): No statistically significant difference was found between group
1 and group 2 regarding mean gestational age at delivery (35.4 +/- 3.4 week
s and 35.9 +/- 3.1 weeks, respectively); mean birth weight (2,318.9 +/- 565
.7 g and 2,138.1 +/- 529.4 g); and the incidence of obstetric complications
. These complications included pregnancy loss (5.2% and 15.7%), pregnancy-i
nduced hypertension (0 and 10%), discordancy (12% and 18.4%), intrauterine
growth restriction (0 and 40%), and gestational diabetes (0% and 6%). Howev
er, the rate of all pregnancy complications was lower among second-trimeste
r MFPR patients.
Conclusion(s): Selective second-trimester MFPR is associated with favorable
perinatal outcome and may facilitate detection of structural and chromosom
al anomalies before the procedure and selective reduction of the affected f
etus. (C) 2000 by American Society for Reproductive Medicine.