Abstract
Introduction: To decrease the risks associated with triplets pregnancies MFPR is preformed. The most frequently applied method is through ultrasound guided transabdominal injection of potassium chloride into the fetal heart or chest cavity at 11-14 weeks of gestation. Aim: The main objective of this study was to evaluate perinatal outcomes in triplet pregnancies after transabdominal MFPR as compared with ongoing triplet pregnancies and twin pregnancies. Material and methods: In this retrospective study, all women with trichorionic triplet pregnancies undergoing MFPR to a twin pregnancy, women with an ongoing trichorionic triplet pregnancy and with those with a primary dichorionic twin pregnancy were included. Results: Median gestation age at delivery was 35.6 ( interquartile range [IQR], 32.8-37 weeks) for triplets reduced to twins, 32.8 weeks (IQR, 27.6-34.7 weeks) for ongoing triplets, and 37 weeks ( IQR, 35.1-38.3 weeks) for primary twins (p <0.01 difference between all groups). There were 7 women in the reduction group (12.28%) vs 10 (19.6%) in the ongoing triplet group, whi and 4 (6.66%) in the primary twin group in whom not a single fetus survived. Preterm delivery before 32 weeks of gestation occurred less in the reduction group compared with the ongoing triplets (12 [20.9%] vs 18 [35.29%] ), but still more often than in primary twins - 7 (11.66%). Conclusion: Multifetal pregnancy reduction (MFPR) seems to be associated with a decreased risk of pregnancy loss both before 24 and 32 weeks of gestation in women with trichorionic triplet reduction.
Highlights
To decrease the risks associated with triplets pregnancies Multifetal pregnancy reduction (MFPR) is preformed
Median gestation age at delivery was 35.6 for triplets reduced to twins, 32.8 weeks (IQR, 27.6-34.7 weeks) for ongoing triplets, and 37 weeks ( IQR, 35.1-38.3 weeks) for primary twins (p
In the event of triplet pregnancy, there remains dabate whether multifetal pregnancy reduction improves obstetrics outcome of triplets reduced to twins
Summary
To decrease the risks associated with triplets pregnancies MFPR is preformed. The most frequently applied method is through ultrasound guided transabdominal injection of potassium chloride into the fetal heart or chest cavity at 11-14 weeks of gestation. Over the past three decades the incidence of triplets and high-order pregnancy has increased from 37 per 100000 in 1980 to 153 per 100000 births in the United States, mainly because of use of assisted reproductive technology (ART) [1]. Medicinski podmladak cording to the data 43% of triplets and high-order pregnancies is a result from IVF, 39% is a consequence form COS and 18% of them occurs spontaneously [2]. Triplet pregnancies are at an increased risk of neonatal morbidity and mortality compared with twin or singleton pregnancy, mainly because of increased risk of preterm birth [3]. Compared with women with twin gestation, those with triplets have a significantly increased risk of maternal morbidity such as gestational diabetes mellitus (GDM), hypertensive disorders such as preeclampsia and cesarean delivery [5]
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