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.
- twin pregnancy
- fetal reduction
- congenital abnormality
- pregnancy outcome
- SELECTIVE TERMINATION