[Clinical study of selective multifetal pregnancy reduction in second trimester]
Xie-tong Wang1, Hong-yan Li, Hao Feng
1Department of Obstetrics and Gynecology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China.
Zhonghua Fu Chan Ke Za Zhi
|June 1, 2007
Summary
Selective second-trimester multifetal pregnancy reduction effectively reduces fetal numbers, improving pregnancy outcomes and increasing birth weight. This safe procedure decreases complications like pre-eclampsia without causing blood coagulation issues or fetal demise in remaining fetuses.
Area of Science:
- Maternal-Fetal Medicine
- Reproductive Medicine
- Perinatology
Context:
- Multiple pregnancies, including twins, triplets, quadruplets, and quintuplets, present significant risks.
- Selective multifetal pregnancy reduction is a procedure to manage high-order multiples.
- Second-trimester intervention is explored for managing these complex pregnancies.
Purpose:
- To evaluate the indications, timing, methods, and outcomes of selective multifetal pregnancy reduction in the second trimester.
- To assess the safety and efficacy of potassium chloride (KCl) injection for feticide.
- To analyze pregnancy complications and outcomes following the procedure.
Summary:
- Trans-abdominal selective multifetal pregnancy reduction was performed on 37 cases (twins to quintuplets) between 12 and 25 weeks gestation.
- Potassium chloride (KCl) was injected intracardiacally to achieve fetal demise in 46 fetuses, with a 100% reduction success rate.
- The overall successful pregnancy rate was 88.9%, with a mean gestational age at delivery of 34.9 weeks, and a reduced incidence of pre-eclampsia.
Impact:
- Selective multifetal pregnancy reduction in the second trimester is a safe and effective method to reduce fetal numbers and associated complications.
- The procedure can lead to improved fetal weight and a decreased incidence of pre-eclampsia.
- It does not appear to cause blood coagulation disturbances or the death of remaining fetuses.
