Multifetal pregnancy reduction was developed to reduce higher-order multiple pregnancies to singleton or twin pregnancies in the attempt to improve several pregnancy outcomes but most importantly preterm birth.1, 2 and 3 With improvements in infertility treatments, the number of triplet and higher-order pregnancies has dropped 9% from 2011 to 2012 and more than a third since its peak in 1998.4 Twin births, however, have remained stable over the last several years.4 The benefit of fetal reduction from twins to singletons remains controversial.
Compared with singleton pregnancies, twin pregnancies are associated with an increase in fetal, infant, and maternal morbidity. Infant morbidity includes an increased risk of intrauterine growth restriction and preterm delivery with the associated complications of prematurity. Maternal morbidity includes an increased risk of gestational diabetes, hypertension, hemorrhage, and cesarean delivery.5
Multifetal reduction from twin pregnancies to singleton pregnancies may be performed for a number of reasons including an increased risk for infant or maternal complications based on maternal or obstetric history, to decrease the known complications of twin pregnancies, or for social reasons. Selective reduction may also be performed because of a genetic or congenital anomaly in one of the fetuses.
Multifetal pregnancy reduction was developed to reduce higher-order multiple pregnancies to singleton or twin pregnancies in the attempt to improve several pregnancy outcomes but most importantly preterm birth.1, 2 and 3 With improvements in infertility treatments, the number of triplet and higher-order pregnancies has dropped 9% from 2011 to 2012 and more than a third since its peak in 1998.4 Twin births, however, have remained stable over the last several years.4 The benefit of fetal reduction from twins to singletons remains controversial.Compared with singleton pregnancies, twin pregnancies are associated with an increase in fetal, infant, and maternal morbidity. Infant morbidity includes an increased risk of intrauterine growth restriction and preterm delivery with the associated complications of prematurity. Maternal morbidity includes an increased risk of gestational diabetes, hypertension, hemorrhage, and cesarean delivery.5Multifetal reduction from twin pregnancies to singleton pregnancies may be performed for a number of reasons including an increased risk for infant or maternal complications based on maternal or obstetric history, to decrease the known complications of twin pregnancies, or for social reasons. Selective reduction may also be performed because of a genetic or congenital anomaly in one of the fetuses.
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