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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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Instrumentation of Near-term Fetal Sheep for Multivariate Chronic Non-anesthetized Recordings
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Fetal reduction for everyone?

Mark I Evans1, Jenifer Curtis2, Shara M Evans2

  • 1Fetal Medicine Foundation of America, USA; Comprehensive Genetics, PC, New York, USA; Department of Obstetrics & Gynecology, Icahn School of Medicine at Mt. Sinai New York, USA.

Best Practice & Research. Clinical Obstetrics & Gynaecology
|June 1, 2022
PubMed
Summary
This summary is machine-generated.

Fetal reduction (FR) significantly lowers risks associated with multiple pregnancies, improving outcomes for twins and higher-order multiples. This procedure is crucial for managing complications from infertility treatments.

Keywords:
AmniocentesisCVSCerebral palsyFetal reductionMultiple pregnancyTwins

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Area of Science:

  • Reproductive Medicine
  • Maternal-Fetal Medicine
  • Genetics

Background:

  • Infertility treatments often result in multiple pregnancies, increasing risks of morbidity and mortality.
  • Fetal reduction (FR) was developed to mitigate these complications.
  • While initially used in high-risk cases, indications for FR have broadened over 30 years.

Purpose of the Study:

  • To evaluate the long-term success and evolving indications of fetal reduction (FR).
  • To assess the impact of FR on reducing morbidity and mortality in multiple pregnancies.
  • To highlight the benefits of combining genetic testing with FR for improved pediatric outcomes.

Main Methods:

  • Review of over 30 years of publications on fetal reduction (FR) techniques.
  • Analysis of outcomes comparing singleton pregnancies with reduced multiples.
  • Integration of chorionic villus sampling (CVS) and microarray analysis for genetic assessment prior to FR.

Main Results:

  • FR has demonstrated significant success in reducing mortality and morbidity in multiple pregnancies.
  • Risks for twins are approximately 4- to 5-fold higher than for singletons.
  • Combining genetic testing (CVS, microarray) with FR improves pediatric outcomes, making reduced multiples statistically similar to lower-order gestations.

Conclusions:

  • Fetal reduction (FR) is a highly successful intervention for managing complications of multiple pregnancies.
  • The proportion of FRs to a singleton has increased, with improved outcomes observed.
  • FR should be discussed and offered to all patients with dichorionic twin pregnancies or higher, as elective single-embryo transfer (eSET) can result in monochorionic twins.