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Do reduced multiples do better?

Mark I Evans1, Doina Ciorica, David W Britt

  • 1Columbia University, Institute for Genetics and Fetal Medicine, New York, NY, USA. mevans@chpnet.org

Best Practice & Research. Clinical Obstetrics & Gynaecology
|July 29, 2004
PubMed
Summary
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Multifetal pregnancy reduction (MFPR) improves outcomes for multiple pregnancies resulting from infertility treatments. Reducing multiple fetuses to twins or singletons enhances maternal and infant health, especially for older women.

Area of Science:

  • Reproductive Medicine
  • Maternal-Fetal Medicine
  • Genetics

Background:

  • Infertility treatments have led to a rise in multiple pregnancies.
  • Multiple pregnancies increase risks of morbidity, mortality, and societal costs.
  • Multifetal pregnancy reduction (MFPR) is a procedure to decrease fetal number.

Purpose of the Study:

  • To evaluate the outcomes of multifetal pregnancy reduction.
  • To assess the safety and efficacy of reducing multiple pregnancies to twins or singletons.
  • To explore the combination of MFPR with chorionic villus sampling.

Main Methods:

  • MFPR performed in the late first trimester.
  • Reduction of multiple fetuses to twins or singletons.
  • Combination of MFPR with chorionic villus sampling in women over 30.

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Main Results:

  • Pregnancies reduced to twins show outcomes comparable to those initially conceived as twins.
  • Patients with triplets have better outcomes when reduced to twins.
  • Reduction to a singleton is increasingly common, particularly for women over 40.
  • Combining MFPR with chorionic villus sampling improves outcomes for the resultant children.

Conclusions:

  • MFPR significantly improves outcomes in multiple pregnancies.
  • Reducing fetal number to twins or singletons is a safe and effective strategy.
  • MFPR combined with chorionic villus sampling maximizes fetal health, especially in older women.