Should multifetal pregnancy reduction be used for prevention of preterm deliveries in triplet or higher order multiple pregnancies?

1998 ◽  
Vol 26 (5) ◽  
pp. 365-370 ◽  
Author(s):  
Emile Papiernik ◽  
Gilles Grangé ◽  
Jennifer Zeitlin
Keyword(s):  
Higher Order ◽  
Multiple Pregnancies ◽  
Multifetal Pregnancy ◽  
Multifetal Pregnancy Reduction

Controversial Issues in the Management of Multiple Pregnancies

Twin Research ◽  
2001 ◽  
Vol 4 (3) ◽  
pp. 165-167 ◽  
Author(s):  
Isaac Blickstein
Keyword(s):  
Mode Of Delivery ◽  
Controversial Issues ◽  
Multiple Pregnancies ◽  
Perinatal Medicine ◽  
Genetic Studies ◽  
Special Cases ◽  
Definition Of ◽  
Multifetal Pregnancy ◽  
Selection Of ◽  
Multifetal Pregnancy Reduction

AbstractThe management of multiple pregnancies represents a true challenge for all sub-specialties concerned with perinatal medicine. Many issues were neglected over the years merely because they were rare and therefore considered not sufficiently important to merit clinical trials. This paper discusses a personal selection of controversial issues, such as multifetal pregnancy reduction of triplets and twins, special cases in multifetal preganncy reduction, need for invasive genetic studies, management of twin-twin transfusion, discordant fetal conditions, the definition of “term” in multiples, and the controversy about the mode of delivery.

scholarly journals Safety and Efficacy of Higher Order Multifetal Pregnancy Reduction: A Single-Center Retrospective Study

2020 ◽  
Vol 10 (03) ◽  
pp. e228-e233
Author(s):  
Yan Liu ◽  
Xie Tong Wang ◽  
Hong Yan Li ◽  
Hai Yan Hou ◽  
Hong Wang ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Birth Weight ◽  
Pregnancy Loss ◽  
Multiple Pregnancy ◽  
Perinatal Outcomes ◽  
Higher Order ◽  
Sample Population ◽  
Safety And Efficacy ◽  
Multifetal Pregnancy ◽  
Multifetal Pregnancy Reduction

Abstract Objective This research was aimed to study the safety and efficacy of higher order multifetal pregnancy reduction (MFPR). Study Design This was a retrospective study of patients from an academic maternity center between 2005 and 2015. We evaluated outcomes of 131 consecutive patients who underwent higher order MFPR (quadruplets and greater). MFPR was performed at 11 to 18 weeks of gestation in all cases. In total, 122 of 131 cases of higher order multiple pregnancy were reduced to twins. We discuss the perinatal outcomes of patients who underwent higher order MFPR, followed by a comparative analysis between the 122 cases of MFPR that were reduced to twins and 101 cases of nonreduced twin pregnancies. Results The study included 104 sets of quadruplets, 20 sets of quintuplets, 5 sets of sextuplets, 1 set of septuplets, and 1 set of octuplets. The perinatal outcomes of the 131 cases were as follows: pregnancy loss, preterm deliveries at 28 to 33 (+6/7) weeks, and preterm deliveries at 34 to 36 (+6/7) weeks occurred in 23.66, 9, and 37% of cases, respectively. The mean time of delivery was 36.56 ± 1.77 weeks, and mean birth weight was 2,409.90 ± 458.16 g, respectively. A total of 122 cases that were reduced to twins were compared with nonreduced twins. The pregnancy loss rate for reduced twins was significantly higher than that for nonreduced twins. The preterm labor rate, mean delivery week, mean birth weight, birth-weight discordance, incidence of gestational diabetes mellitus, and pregnancy-induced hypertension were not significantly different between the groups (p > 0.05). Conclusion Perinatal outcomes were significantly improved by reducing the number of fetuses in higher order multifetal pregnancies. This study involved a large, diverse sample population, and the results can be used as a reference while conducting prenatal counseling.

scholarly journals Recovery of second trimester pre-eclampsia after fetal reduction of a triplet

2019 ◽  
Vol 12 (9) ◽  
pp. e227667
Author(s):  
Jeske M bij de Weg ◽  
Christianne J de Groot ◽  
Eva Pajkrt ◽  
Marjon A de Boer
Keyword(s):  
Severe Hypertension ◽  
Multiple Pregnancy ◽  
Second Trimester ◽  
Multiple Pregnancies ◽  
Review Of The Literature ◽  
Hypertensive Disorders Of Pregnancy ◽  
Triplet Pregnancy ◽  
Increased Risk ◽  
Multifetal Pregnancy ◽  
Multifetal Pregnancy Reduction

Women with a multiple pregnancy are at increased risk of developing hypertensive disorders of pregnancy. We describe a case of a dichorionic triamniotic triplet pregnancy complicated by severe hypertension, proteinuria and maternal symptoms, fitting with the diagnosis of pre-eclampsia, apart from the early gestational age of only 16 weeks. After reduction of the monochorionic pair, the disease resolved and pre-eclampsia was diagnosed again at 30 weeks of gestation, resulting in a delivery on maternal indication at 33 weeks of gestation. In a review of the literature, we found six papers including eight cases on multifetal pregnancy reduction on maternal indication. Multifetal pregnancy reduction resulted in a prolongation of pregnancy of two to 21 weeks and may be considered in extreme early onset pre-eclampsia in dichorionic multiple pregnancies.

scholarly journals Abortion and multifetal pregnancy reduction: An ethical comparison

2021 ◽  
Author(s):  
Silje Langseth Dahl ◽  
Rebekka Hylland Vaksdal ◽  
Mathias Barra ◽  
Espen Gamlund ◽  
Carl Tollef Solberg
Keyword(s):  
Medical Ethics ◽  
Psychological Effects ◽  
Multiple Pregnancies ◽  
Relevant Difference ◽  
Abortion Debate ◽  
Abortion Legislation ◽  
Moral Distinction ◽  
Multifetal Pregnancy ◽  
Multifetal Pregnancy Reduction

In recent years, multifetal pregnancy reduction (MFPR) has increasingly been a subject of debate in Norway. The intensity of this debate reached a tentative maximum when the Legislation Department delivered their interpretative statement, Section 2 - Interpretation of the Abortion Act, in 2016 in response to a request from the Ministry of Health (2014) that the Legislation Department consider whether the Abortion Act allows for MFPR of healthy fetuses in multiple pregnancies. The Legislation Department concluded that the current abortion legislation [as of 2016] allows for MFPR subject to the constraints that the law otherwise stipulates. The debate has not subsided, and during autumn 2018 it was further intensified in connection with the Norwegian Christian Democratic "crossroads" policy and signals from the Conservatives to consider removing section 2.3c and to forbid MFPR. Many of the arguments in the MFPR debate are seemingly similar to arguments put forward in the general abortion debate, and an analysis to ascertain what distinguishes MFPR from other abortions has yet to be conducted. The aim of this article is, therefore, to examine whether there is a moral distinction between abortion and MFPR of healthy fetuses. We will cover the typical arguments emerging in the debate in Norway and exemplify them with scholarly articles from the literature. We have dubbed the most important arguments against MFPR that we have identified the harm argument, the slippery-slope argument, the intention argument, the grief argument, the long-term psychological effects for the woman argument, and the sorting argument. We conclude that these arguments do not measure up in terms of demonstrating a morally relevant difference between MFPR of healthy fetuses and other abortions. Our conclusion is, therefore — despite what several discussants seem to think — that there is no morally relevant difference between the two. Therefore, on the same conditions as we allow for abortions, we should also allow MFPR. Keywords: abortion, ethics, medical ethics, MFPR, selective MFPR

Management and multifetal pregnancy reduction of higher-order multifetal pregnancy with monochorionic twin pairs

2016 ◽  
Vol 22 (6) ◽  
pp. 120
Author(s):  
O. V. Pribushenya¹ ◽  
S. A. Kotova² ◽  
V. I. Rybakova ◽  
I. S. Tsybovsky
Keyword(s):  
Higher Order ◽  
Monochorionic Twin ◽  
Multifetal Pregnancy ◽  
Multifetal Pregnancy Reduction
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