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Amniocentesis after multifetal pregnancy reduction: is it safe?
J A Stephen1, I E Timor-Tritsch, J P Lerner
1Department of Obstetrics and Gynecology, Columbia Presbyterian Medical Center, New York, New York, USA.
American Journal of Obstetrics and Gynecology
|April 14, 2000
Summary
Elective amniocentesis after multifetal pregnancy reduction did not significantly alter pregnancy loss or early delivery rates. Outcomes for women undergoing amniocentesis were comparable to those who did not have the procedure.
Area of Science:
- Reproductive Medicine
- Maternal-Fetal Medicine
- Obstetrics
Background:
- Multifetal pregnancy reduction (MFPR) is a procedure to manage high-order multiples.
- Subsequent elective amniocentesis is sometimes performed after MFPR.
- Understanding the impact of amniocentesis on obstetric outcomes post-MFPR is crucial.
Purpose of the Study:
- To review obstetric outcomes in women undergoing MFPR who subsequently had elective amniocentesis.
- To compare pregnancy loss and early delivery rates between women with and without subsequent amniocentesis post-MFPR.
Main Methods:
- Retrospective review of 508 patients undergoing MFPR.
- Analysis of obstetric outcomes for 91 patients who had subsequent elective amniocentesis.
- Logistic regression and multivariate conditional likelihood analysis to assess factors associated with pregnancy loss.
Main Results:
- The uncorrected pregnancy loss rate was 9.0% and early premature delivery rate was 4.5% in the amniocentesis group.
- Number of fetuses removed, final number of fetuses, and procedure protocol significantly impacted loss rates.
- Adjusted odds ratio for amniocentesis and pregnancy loss was 0.7 (95% CI, 0.3-1.5; P=.3).
Conclusions:
- Pregnancy loss and early delivery rates following MFPR with subsequent amniocentesis are comparable to those without amniocentesis.
- Elective amniocentesis does not appear to adversely affect obstetric outcomes post-MFPR.
- MFPR outcomes are influenced by the number of fetuses reduced and the final number of fetuses.
