Maternal Fetal Medicine
Maryam Nurzadeh; Maryam Moshfeghi; Mamak Shariat; Ashraf Sadat Jamal; Vajiheh Marsoosi; Laleh Eslamian; Mahsa Naemi; Maria Nezam Nia; Fedyeh Haghollahi; Seyede Houra Mousavi Vahed
Volume 8, Issue 4 , July and August 2023, , Pages 335-341
Abstract
Background & Objective: A number of procedures have been developed for multifetal pregnancy reduction (MPR) to reduce the overall number of fetuses in the gestation and improve the maternal outcomes as well as the outcomes of the surviving fetus.Materials & Methods: An observational ...
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Background & Objective: A number of procedures have been developed for multifetal pregnancy reduction (MPR) to reduce the overall number of fetuses in the gestation and improve the maternal outcomes as well as the outcomes of the surviving fetus.Materials & Methods: An observational historical cohort study was conducted on multiple pregnancies that underwent fetal reduction in Shariati Hospital and Omid Clinic between January 2018 and September 2021. The study population was divided into two groups according to gestational age at fetal reduction: 11–14 weeks' gestation (early reduction group) and 15–19 weeks’ gestation (late reduction group). The main outcome measures were the rates of pregnancy complications, pregnancy loss, preterm delivery, and adverse neonatal outcomes.Results: The study group included 107 patients with twin and multiple pregnancies that underwent abdominal MPR at 11-19 weeks’ gestation (79 in the early reduction group and 28 in the late group). The incidence of pregnancy complications (hypertension, diabetes, intrauterine growth disorder, preterm delivery, and pregnancy loss) was not significantly different between the two groups (P >0.05). The percentage of NICU admission was higher in the early reduction group compared to the late group (49% vs 18.5%, P=0.004). The weight of the first newborn was significantly heavier in the late versus early reduction group (2680.55±777.52 vs 2264.4±796.82, P=0.005).Conclusion: According to the present study, fetal reduction in twin or multiple pregnancies is a safe procedure with good obstetric outcomes if done by an expert specialist, especially when it is performed in the second trimester.
Obstetrics and Gynecology
Tyurina Natalya Alexandrovna; Fomicheva Tatyana Vladimirovna; Laksaev Vladislav Petrovich; Naumova Irina Sergeevna; Goryachkina Daria Valerievna; Minashkina Alina Sergeevna; Shukshina Olga Ivanovna; Kanunova Tatyana Andreevna
Volume 8, Issue 4 , July and August 2023, , Pages 382-388
Abstract
Background & Objective: There is a well-established link between multiple pregnancies and assisted reproductive techniques (ARTs). Increased maternal and perinatal morbidity and mortality are directly related to multiple pregnancies. The purpose of the current study is to examine the effects ...
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Background & Objective: There is a well-established link between multiple pregnancies and assisted reproductive techniques (ARTs). Increased maternal and perinatal morbidity and mortality are directly related to multiple pregnancies. The purpose of the current study is to examine the effects of multiple pregnancies on women using various reproductive techniques.Materials & Methods: This study used a comparative-analytical approach. We assessed a cohort of 130 pregnant women of which 120 had twins and 10 had triplets. In vitro fertilization and embryo transfer (IVF-ET) were performed on 62.0% of women, while 6.0% had ovulation induction. Using ultrasound examination, twin and triplet pregnancies were found in 92% and 8%, respectively.Results: Our results show that 11% of women experience the physiological course of pregnancy with multiple pregnancies. Pregnancy concludes in the delivery of twins only in 50% of patients with multiple pregnancies diagnosed by ultrasound examination before 10 weeks. It was found that 46% of births in women carrying multiple pregnancies happened prematurely after studying more than 100 births. Of these, 6% occurred before 28 weeks, 20% between 29 and 34 weeks, and 20% between 35 and 37 weeks.Conclusion: Preeclampsia and placental insufficiency are more likely to occur in multiple pregnancies than in single pregnancies. As a result, at the beginning of the second trimester, all preventative measures should be implemented. Although abdominal delivery is not the preferred option for multiple pregnancies, there is a need to increase the indications for surgical delivery for the benefit of the fetuses.
Reproductive Medicine
Ayman Dawood; Mohamed Elnamoury; Walid Atallah
Volume 7, Issue 2 , September and October 2021, , Pages 99-104
Abstract
Background & Objective: Multifetal reduction not only lowers the number of fetuses but also improves pregnancy outcomes. A great conflict emerges when obstetrician faces triplet or higher order multifetal pregnancies. Decision-making is so difficult whether to continue pregnancy as such with ...
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Background & Objective: Multifetal reduction not only lowers the number of fetuses but also improves pregnancy outcomes. A great conflict emerges when obstetrician faces triplet or higher order multifetal pregnancies. Decision-making is so difficult whether to continue pregnancy as such with its risks or reduce the number of fetuses to improve outcomes. This study aimed to assess the obstetrical outcomes of Embryo Reduction to Twins (ERTT) procedures in IVF/ICSI centers in Egypt.Materials & Methods: This retrospective cross-sectional study was conducted from June 2017 to December 2020. Data of the patients in five IVF/ICSI centers were accessed using the computer-stored patients' files. Patients who got pregnant spontaneously or after IVF/ICSI procedures with 3 or more embryos were recruited in the study. The patients were counseled for ERTT and those who accepted the procedure were included. The measured obstetrical outcomes were abortion rate, preterm labor, and preeclampsia, premature rupture of membranes, and neonatal morbidity and mortality.Results: One hundred and twenty four cases were included in this study from 5 IVF/ICSI centers. Most cases (83.87%) of multifetal pregnancies were due to IVF/ICSI procedures. The mean age was 28.3 ± 2.5 years and the mean gestational age at reduction was 8.4 ± 0.6 weeks. The great majority of cases (72.58%) were operated by aspiration. The abortion rate was 29.84%. The mean gestation age at delivery was 34.51 ± 1.82 weeks. The incubator admission rate was 41.93% and the overall postoperative complication was 9.68%.Conclusion: Embryo Reduction to Twins in triplets or higher order pregnancies was considered feasible, safe and linked to minimal complications. The ERTT procedure improved obstetrical and neonatal outcomes.
