Clinical Results of Transvaginal Multifetal Pregnancy Reduction According to the Gestational Period

Cheon, Dae Joon; Kang, Eun Hee; Chu, Hyung Sik; Chae, Hee Dong; Kim, Chung Hoon; Kang, Byung Moon; Chang, Yoon Seok; Mok, Jung Eun

Abstract

OBJECTIVE
To compare the pregnancy outcomes of transvaginal multifetal pregnancy reduction (MFPR) according to the gestational period when the procedure was performed
METHODS
From January l995 to February 1998, total 27 patients with multiple pregnancy were included in this study. The patients were grouped to early MFPR group (<8 weeks, n=16) and delayed MFPR group (>8 weeks, n=ll) according to the gestational age that MFPRs were performed. All MFPRs were performed by transvaginal sonography-guided fetal aspiration or mechanical trauma. The complete pregnancy loss rate before 24 weeks of gestation, spontaneous loss of embryo, procedure-related complication, gestational age at delivery, and pregnancy complication were compared between the two groups. Statistical analysis of data was performed using Students t-test and Fishers exact test as appropriate. Statistical significance was defined as p<0.05.
RESULTS
There was no significant difference in the complete pregnancy loss rate between the early MFPR group (6.3%) and the delayed MFPR group (27.3%). The incidence of partial spontaneous loss of embryo in the two groups were not differed significantly (6.3% vs. 18.2%). The procedure-related complication of the delayed MFPR group (36.4%) seemed to be higher than that of the early MFPR group (6.3%), however there was no statistical difference (p=0, 07). Especially, all 3 patients in whom the MFPR was performed after 10 weeks suffered from the procedure-related complication. The mean gestational age at delivery of the two groups were not differed significantly (36.3+2.8 weeks vs. 37.0+1.3 weeks). There was also no significant difference in the mean birth weights of the two groups (2378.8+563.7 gm vs. 2427.1+436.2 gm).
CONCLUSION
Although there was no statistically significant difference, the early transvaginal MFPR might be a safe and useful method without significant adverse complications compared to the delayed MFPR.