Efficacy and Safety of Selective Fetal Reduction in Multiple Pregnancy

Kwon, Su Kyoung; Kim, Sung Hoon; Lee, Kyong Hee; Chae, Hee Dong; Kim, Chung Hoon; Kang, Byung Mun

Abstract

OBJECTIVES
To investigate the efficacy and effectiveness of selective fetal reduction (SFR) in multiple pregnancy achieved by controlled ovarian hyperstimulation (COH).
METHODS
From January 1997 to July 2012, transvaginal SFR was performed in 100 multiple pregnancies achieved by COH. We performed SFR utilizing the mechanical destruction and/or absorption of the embryo with amniotic fluid aspiration at 7 to 8 weeks of gestation. After transvaginal SFR, 100 pregnancies were evaluated and analyzed retrospectively with medical records. In addition, the pregnancy outcome of triplet pregnancies was compared between SFR group and expectant management group, retrospectively.
RESULTS
Among 100 SFR cases, fetal loss of all fetuses occurred in 13 patients before 24 weeks of gestation and 56 patients were delivered after 36weeks of gestation. When we compared the pregnancy outcome of triplet pregnancies between SFR group and expectant management group, the proportion of delivery after 36 weeks was significantly higher in SFR group compared to expectant management group, while the proportion of delivery at 28~35 weeks was significantly lower in SFR group compared to expectant management group.
CONCLUSION
The early transvaginal SFR performed at 7 to 8 weeks of gestation appeared to be a simple and relatively safe procedure. The successful outcomes of reduced multiple pregnancy may be improved by more experience with SFR.