Perinatal outcome after multifetal reduction to twins compared with nonreduced multiple gestations

Area of Science:

• Maternal-Fetal Medicine
• Reproductive Endocrinology
• Neonatology

Background:

• Ovulation induction frequently results in multiple gestations, posing risks to both mother and neonate.
• Multifetal pregnancy reduction (MFP) is a procedure to improve outcomes by decreasing the number of fetuses.
• The comparative outcomes of multifetal reduction versus non-reduced higher-order multiples require detailed analysis.

Purpose of the Study:

• To analyze outcomes of twins resulting from multifetal reduction.
• To compare these outcomes with non-reduced triplet and quadruplet pregnancies.
• To assess similarity to outcomes of twin pregnancies not involving multifetal reduction.

Main Methods:

• Retrospective analysis of maternal and perinatal outcomes.
• Study included 62 infertile women with multiple gestations conceived via ovulation induction.
• Outcomes compared between reduced multiples, non-reduced multiples, and natural twins.

Main Results:

• Quadruplets had significantly lower gestational age (24.8 weeks) and higher mortality (62%) than twins reduced from quadruplets (31.0 weeks).
• Twins reduced from triplets showed improved gestational age (34.8 weeks) and birth weight (2305g) compared to non-reduced triplets (33.1 weeks; 1924.7g).
• Reduced twins had shorter neonatal intensive care unit stays and better outcomes than non-reduced higher-order multiples, but lower gestational age and birth weight than natural twins.

Conclusions:

• Multifetal reduction significantly improves perinatal outcomes compared to non-reduced triplet and quadruplet pregnancies.
• While outcomes are improved, twins resulting from multifetal reduction still show poorer outcomes than non-reduced twin pregnancies.
• MFP is a viable option to mitigate risks associated with higher-order multiple gestations.