Pregnancy outcome after fetal reduction in women with a dichorionic twin pregnancy

L. van de Mheen*, S. M. P. Everwijn, M. F. C. M. Knapen, M. C. Haak, M. A. J. Engels, G. T. R. Manten, H. A. Zondervan, S. A. M. Wirjosoekarto, J. M. G. van Vugt, J. J. H. M. Erwich, C. M. Bilardo, M. G. van Pampus, C. J. M. de Groot, B. W. J. Mol, E. Pajkrt

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

17 Citations (Scopus)

Abstract

STUDY QUESTION: What are the pregnancy outcomes for women with a twin pregnancy that is reduced to a singleton pregnancy?

summary answer: Fetal reduction of a twin pregnancy significantly improves gestational age at birth and neonatal birthweight, however at an increased risk of pregnancy loss and preterm delivery.

what is known already: Women with a multiple pregnancy are at increased risk for preterm delivery. Fetal reduction can be considered in these women.

study design, size, and duration: Retrospective cohort study of 118 women with a twin pregnancy reduced to a singleton pregnancy between 2000 and 2010.

participants/materials, setting, and methods: We compared the outcome of pregnancy in consecutive women with a dichorionic twin pregnancy that was reduced to a singleton pregnancy to that of women with a dichorionic twin pregnancy that was managed expectantly and women with a primary singleton pregnancy. Reductions were performed between 10-23(6/7) weeks' gestation by intracardiac or intrathoracic injection of potassium chloride, mostly for congenital anomalies. We compared median gestational age, pregnancy loss

main results and the role of chance: We studied 118 women with a twin pregnancy that was reduced to a singleton, 818 women with an ongoing dichorionic twin pregnancy and 611 women with a primary singleton pregnancy. Loss of the entire pregnancy

limitations, reasons forcaution: The main limitations of the study were its retrospective character, and the fact that indications for reduction were heterogeneous.

wider implications of the findings: In women with a dichorionic twin pregnancy fetal reduction increases median gestational age only at considerable risk of complete early pregnancy loss.

Original languageEnglish
Pages (from-to)1807-1812
Number of pages6
JournalHuman Reproduction
Volume30
Issue number8
DOIs
Publication statusPublished - Aug-2015

Keywords

  • twin pregnancy
  • fetal reduction
  • congenital abnormality
  • pregnancy outcome
  • SELECTIVE TERMINATION
  • DISCORDANT
  • MANAGEMENT
  • EXPERIENCE
  • SINGLETON
  • ANOMALIES

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