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Invasive procedures in multiple gestations.

Meredith Rochon1, Joanne Stone

  • 1Department of Obstetrics, Gynecology, and Reproductive Science, Division of Maternal-Fetal Medicine, Mount Sinai Medical Center, New York, New York 10029, USA. meredith.rochon@mssm.edu

Current Opinion in Obstetrics & Gynecology
|March 14, 2003
PubMed
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Invasive procedures for multiple gestations are common. With experienced practitioners, risks like pregnancy loss are low for procedures such as chorionic villus sampling and multifetal pregnancy reduction.

Area of Science:

  • Maternal-Fetal Medicine
  • Reproductive Medicine
  • Genetics

Background:

  • Assisted reproductive techniques have increased multiple gestations.
  • This has led to a rise in invasive procedures for these pregnancies.
  • Procedures include amniocentesis, chorionic villus sampling, multifetal pregnancy reduction, and selective termination.

Purpose of the Study:

  • To review the current status and outcomes of invasive procedures in multiple gestations.
  • To assess the safety and efficacy of these procedures in light of increased incidence.

Main Methods:

  • Review of recent literature and studies on invasive procedures in multiple gestations.
  • Analysis of pregnancy loss rates associated with different procedures and gestations.

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Main Results:

  • Pregnancy loss rates for chorionic villus sampling, multifetal pregnancy reduction, and selective termination have decreased with operator experience.
  • Amniocentesis in twins may have a higher post-procedural loss rate compared to singletons.
  • Selective termination after 20 weeks gestation shows no increased loss rates in experienced hands.

Conclusions:

  • Invasive procedures in multiple gestations are now common and increasingly safe.
  • Optimizing assisted reproductive techniques for primary prevention of high-order multiples is crucial to reduce the need for these interventions.