Twin pregnancies with a 'vanished' embryo: a higher risk multiple gestation group?
S E Barton1, S A Missmer, M D Hornstein
1Department of Obstetrics and Gynecology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA. sbarton@partners.org
Human Reproduction (Oxford, England)
|July 26, 2011
Summary
IVF twin pregnancies resulting from a vanished triplet have a higher risk of early preterm birth (<32 weeks) and shorter gestation. Increased obstetrical monitoring is recommended for these high-risk pregnancies.
Area of Science:
- Reproductive Medicine
- Perinatology
- Obstetrics
Background:
- Vanished twin syndrome in IVF pregnancies is associated with adverse perinatal outcomes.
- Limited data exists on the impact of vanishing an early triplet on subsequent twin gestations.
Purpose of the Study:
- To evaluate the perinatal risks in IVF twins originating from a vanished triplet pregnancy.
- To compare outcomes such as small for gestational age (SGA), low birthweight (LBW), and preterm birth.
Main Methods:
- Retrospective cohort study of 829 IVF twin deliveries.
- Multivariate analysis to assess perinatal risks in twins from vanished triplet pregnancies versus controls.
- Outcomes analyzed: SGA, LBW, preterm delivery (<37 weeks), and early preterm delivery (<32 weeks).
Main Results:
- 7.1% of IVF twin deliveries (59/829) resulted from vanished triplet pregnancies.
- No significant increase in SGA, LBW, or delivery <37 weeks.
- Significantly higher risk of early preterm birth (<32 weeks) (OR 3.09).
- Average gestation was 1.5 weeks shorter, with a mean birthweight nearly 200g lower.
Conclusions:
- IVF twin pregnancies with a history of a vanished triplet face increased risk of early preterm birth.
- These pregnancies warrant recognition as high-risk and may benefit from enhanced obstetrical surveillance.
- The specific causes of preterm birth in this cohort remain undetermined.
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