Multifetal pregnancy reduction: Perinatal and fiscal outcomes

OBJECTIVE: This study was undertaken to compare the birth outcomes of a mul tifetal pregnancy reduction population with those of other patients deliver ed at Hutzel Hospital, Detroit, and to determine the fiscal impact of the m ultifetal pregnancy reduction program. STUDY DESIGN: in a retrospective review patients who were delivered after m ultifetal pregnancy reduction were compared with a general obstetric popula tion who were delivered at Hutzel Hospital from January 1, 1986, through Ju ne 30, 1998. Outcome data were determined through a comprehensive perinatal database. The chi(2) analysis was used to examine the relationship between gestational age and delivery group. Financial data were estimated from pub lished reports of neonatal intensive care unit admissions, cost estimates f or neonatal intensive care unit care, and charges for multifetal pregnancy reduction. RESULTS: Pregnancies reduced to triplets, twins, and singletons had outcome s at least comparable to unreduced pregnancies starting at these numbers an d substantially better than unreduced pregnancies with the same starting nu mber. Financial estimates of hospitalization costs averted in the multifeta l pregnancy reduction population exceeded $28 million. CONCLUSION: Use of multifetal pregnancy reduction improved obstetric outcom es for pregnancies with multiple gestations and also was associated with si gnificant fiscal savings.