Pregnancy Outcomes After Higher-Order Multifetal Pregnancy Reduction: A Retrospective Study

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Clinical Practice Pub Date : 2025-03-25 DOI:10.1155/ijcp/2512443

Mengjie Fan, Li Li, Yanyi Li, Liying Wang, Hongxia Zhang, Shuo Yang, Jia Li, Ying Song, Di Sun, Danlei Zheng, Tian Tian, Caihong Ma, Ping Liu, Jie Qiao, Rui Yang, Rong Li

{"title":"Pregnancy Outcomes After Higher-Order Multifetal Pregnancy Reduction: A Retrospective Study","authors":"Mengjie Fan, Li Li, Yanyi Li, Liying Wang, Hongxia Zhang, Shuo Yang, Jia Li, Ying Song, Di Sun, Danlei Zheng, Tian Tian, Caihong Ma, Ping Liu, Jie Qiao, Rui Yang, Rong Li","doi":"10.1155/ijcp/2512443","DOIUrl":null,"url":null,"abstract":"<div>\n Objective: To investigate the pregnancy outcomes after transvaginal or transabdominal fetal reduction for higher-order multifetal pregnancies with four or more fetuses.\n Methods: This retrospective study included 102 patients with higher-order multifetal pregnancies after ovulation induction. The patients underwent fetal reduction in the Reproductive Medical Center of Peking University Third Hospital from January 2000 to December 2020. Methods of fetal reduction included transvaginal and transabdominal reduction. Pregnancy outcomes of different methods were assessed, including the live birth rate, miscarriage rate, preterm labor rate, and low birthweight rate.\n Results: Among these 102 patients, 84 (82.4%) underwent transvaginal fetal reduction in early pregnancy, and 18 (17.6%) underwent transabdominal reduction in the second trimester. The live birth rate (66% vs. 78%, p = 0.311), preterm labor rate (24% vs. 33%, p = 0.587), and miscarriage rate (25% vs. 17%, p = 0.653) were comparable for transvaginal and transabdominal fetal reduction. Age, the method of fetal reduction, and the initial number and retained number of fetuses were not influencing factors of the live birth rate or miscarriage rate in these patients.\n Conclusion: Prevention is the most important measure to decrease the incidence of multiple pregnancies. For higher-order multifetal pregnancies, multifetal pregnancy reduction (MFPR) is considered a significant remedial measure. Transvaginal fetal reduction in the first trimester of pregnancy and transabdominal fetal reduction in the second trimester were both safe and effective.\n </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/2512443","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Clinical Practice","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1155/ijcp/2512443","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: To investigate the pregnancy outcomes after transvaginal or transabdominal fetal reduction for higher-order multifetal pregnancies with four or more fetuses.

Methods: This retrospective study included 102 patients with higher-order multifetal pregnancies after ovulation induction. The patients underwent fetal reduction in the Reproductive Medical Center of Peking University Third Hospital from January 2000 to December 2020. Methods of fetal reduction included transvaginal and transabdominal reduction. Pregnancy outcomes of different methods were assessed, including the live birth rate, miscarriage rate, preterm labor rate, and low birthweight rate.

Results: Among these 102 patients, 84 (82.4%) underwent transvaginal fetal reduction in early pregnancy, and 18 (17.6%) underwent transabdominal reduction in the second trimester. The live birth rate (66% vs. 78%, p = 0.311), preterm labor rate (24% vs. 33%, p = 0.587), and miscarriage rate (25% vs. 17%, p = 0.653) were comparable for transvaginal and transabdominal fetal reduction. Age, the method of fetal reduction, and the initial number and retained number of fetuses were not influencing factors of the live birth rate or miscarriage rate in these patients.

Conclusion: Prevention is the most important measure to decrease the incidence of multiple pregnancies. For higher-order multifetal pregnancies, multifetal pregnancy reduction (MFPR) is considered a significant remedial measure. Transvaginal fetal reduction in the first trimester of pregnancy and transabdominal fetal reduction in the second trimester were both safe and effective.

查看原文本刊更多论文

高阶多胎妊娠减少后妊娠结局：一项回顾性研究

目的：探讨四胎以上高阶多胎妊娠经阴道或经腹部胎位复位后的妊娠结局。方法：回顾性研究102例诱导排卵后高阶多胎妊娠患者。患者于2000年1月至2020年12月在北京大学第三医院生殖医学中心行胎儿复位术。胎儿复位方法包括经阴道复位和经腹部复位。评估不同方法的妊娠结局，包括活产率、流产率、早产率和低出生体重率。结果：102例患者中，84例（82.4%）在妊娠早期进行了经阴道胎位降低，18例（17.6%）在妊娠中期进行了经腹部胎位降低。活产率（66%对78%，p = 0.311）、早产率（24%对33%，p = 0.587）和流产率（25%对17%，p = 0.653）经阴道和经腹部胎位复位具有可比性。年龄、胎位减少方式、胎位起始数和胎位保留数均不是影响患者活产率和流产率的因素。结论：预防是降低多胎妊娠发生率的重要措施。对于高阶多胎妊娠，减少多胎妊娠（MFPR）被认为是一种重要的补救措施。妊娠早期经阴道胎儿复位和妊娠中期经腹部胎儿复位都是安全有效的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

International Journal of Clinical Practice 医学-医学：内科

CiteScore

5.30

自引率

0.00%

发文量

274

审稿时长

3-8 weeks

期刊介绍： IJCP is a general medical journal. IJCP gives special priority to work that has international appeal. IJCP publishes: Editorials. IJCP Editorials are commissioned. [Peer reviewed at the editor''s discretion] Perspectives. Most IJCP Perspectives are commissioned. Example. [Peer reviewed at the editor''s discretion] Study design and interpretation. Example. [Always peer reviewed] Original data from clinical investigations. In particular: Primary research papers from RCTs, observational studies, epidemiological studies; pre-specified sub-analyses; pooled analyses. [Always peer reviewed] Meta-analyses. [Always peer reviewed] Systematic reviews. From October 2009, special priority will be given to systematic reviews. [Always peer reviewed] Non-systematic/narrative reviews. From October 2009, reviews that are not systematic will be considered only if they include a discrete Methods section that must explicitly describe the authors'' approach. Special priority will, however, be given to systematic reviews. [Always peer reviewed] ''How to…'' papers. Example. [Always peer reviewed] Consensus statements. [Always peer reviewed] Short reports. [Always peer reviewed] Letters. [Peer reviewed at the editor''s discretion] International scope IJCP publishes work from investigators globally. Around 30% of IJCP articles list an author from the UK. Around 30% of IJCP articles list an author from the USA or Canada. Around 45% of IJCP articles list an author from a European country that is not the UK. Around 15% of articles published in IJCP list an author from a country in the Asia-Pacific region.