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Selective reduction in multifetal pregnancies: technical and psychological aspects.

D Vauthier-Brouzes1, G Lefebvre

  • 1Groupe Hospitalier Pitié-Salpêtrière, Paris, France.

Fertility and Sterility
|May 1, 1992
PubMed
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Very early transvaginal selective embryo reduction in multifetal pregnancies is a safe and effective procedure. This method, performed at seven weeks of amenorrhea, resulted in healthy neonates without complications, offering a necessary option for high-order multiples.

Area of Science:

  • Reproductive Medicine
  • Maternal-Fetal Medicine
  • Obstetrics

Background:

  • Multifetal pregnancies present increased risks for both mother and neonates.
  • Selective embryo reduction is a procedure to improve pregnancy outcomes in cases of high-order multiples.

Purpose of the Study:

  • To evaluate the efficiency and safety of a very early transvaginal selective embryo reduction procedure.
  • To assess pregnancy outcomes and psychological impact in patients undergoing this intervention.

Main Methods:

  • Prospective study involving 22 patients with multifetal pregnancies (triplets to quintuplets).
  • Selective embryonic reduction performed at 7 weeks of amenorrhea via transvaginal embryo puncture and aspiration, leaving two embryos.
  • Evaluation of pregnancy outcomes, including complications, delivery term, and neonatal health, alongside psychological impact.
Keywords:
Abortion, InducedBehaviorContraceptionContraceptive UsageDecision MakingDeveloped CountriesEconomic FactorsEuropeFamily PlanningFertility Control, PostconceptionFranceGynecologic SurgeryMediterranean CountriesMethod AcceptabilityPregnancyPregnancy OutcomesPregnancy, MultipleProspective StudiesPsychological FactorsReproductionResearch MethodologySocioeconomic FactorsStudiesSurgeryTreatmentUrogenital SurgeryWestern Europe

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Main Results:

  • No immediate or delayed complications were observed following the procedure.
  • All 22 patients delivered at an average of 36.5 weeks of amenorrhea, resulting in 44 healthy neonates with no congenital malformations.
  • While the procedure caused anxiety, patients perceived it as necessary for successful pregnancy outcomes.

Conclusions:

  • Very early transvaginal embryo reduction at 7 weeks of amenorrhea, leaving two embryos, is a simple and safe procedure.
  • The procedure does not negatively affect the remaining fetuses.
  • Recommended for pregnancies with four or more embryos and should be considered for triplets, with patients viewing it as a necessary intervention.