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Related Concept Videos

Fetal Circulation01:14

Fetal Circulation

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Fetal circulation is a unique system that facilitates the exchange of gases, nutrients, and waste products between the developing fetus and the mother. This intricate process takes place through a special organ called the placenta.
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...
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The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
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Updated: Oct 15, 2025

Model Surgical Training: Skills Acquisition in Fetoscopic Laser Photocoagulation of Monochorionic Diamniotic Twin Placenta Using Realistic Simulators
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Model Surgical Training: Skills Acquisition in Fetoscopic Laser Photocoagulation of Monochorionic Diamniotic Twin Placenta Using Realistic Simulators

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Fetal reduction and twins.

Mark I Evans1, Jenifer Curtis2, Shara M Evans3

  • 1Comprehensive Genetics, Fetal Medicine Foundation of America, New York, NY (Dr Evans, Ms Curtis, Ms Evans, and Dr Britt); Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY (Dr Evans).

American Journal of Obstetrics & Gynecology MFM
|October 26, 2021
PubMed
Summary
This summary is machine-generated.

Fetal reduction significantly lowers risks associated with multiple pregnancies, improving outcomes for dichorionic twins. Discussing this option with patients is crucial for better maternal and infant health.

Keywords:
amniocentesiscerebral palsychorionic villus samplingfetal reductionmultiple pregnancytwins

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Area of Science:

  • Reproductive Medicine
  • Maternal-Fetal Medicine
  • Medical Ethics

Background:

  • Infertility treatments increase multiple pregnancies, leading to higher morbidity and mortality.
  • Fetal reduction was developed to mitigate complications of multiple gestations.
  • Risks of twin pregnancy are 4-5 times higher than singleton pregnancy.

Purpose of the Study:

  • To evaluate the long-term success and evolving indications of fetal reduction.
  • To assess the impact of genetic testing and microarray analysis on fetal reduction outcomes.
  • To compare outcomes of fetal reduction to elective single-embryo transfer, particularly for monochorionic twins.

Main Methods:

  • Review of over 30 years of publications on fetal reduction.
  • Analysis of outcomes combining chorionic villus sampling, microarray analysis, and fetal reduction.
  • Comparison of pregnancy outcomes based on fetal number and chorionicity.

Main Results:

  • Fetal reduction has proven highly successful in reducing multiple pregnancy complications.
  • Genetic testing combined with fetal reduction leads to outcomes comparable to lower-order multiples.
  • The proportion of twin-to-singleton reductions has increased, showing improved pediatric outcomes.
  • Monochorionic twins, often a result of elective single-embryo transfer, have higher complication rates and are difficult to reduce.

Conclusions:

  • Fetal reduction should be discussed and offered to all patients with dichorionic twin pregnancies or higher.
  • While elective single-embryo transfer is suitable for some, transferring two embryos may be more rational for many couples.
  • Advances in genetic testing enhance fetal selection for reduction, improving pediatric outcomes.