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Fertil Steril. 2011 Feb;95(2):596-9. doi: 10.1016/j.fertnstert.2010.06.013. Epub 2010 Jul 24.

Spontaneous reduction before 12 weeks' gestation and selective reduction similarly extend time to delivery in in vitro fertilization of trichorionic-triamniotic triplets.

Author information

1
Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA.

Abstract

OBJECTIVE:

To determine the prevalence and the relative benefits conferred by selective and spontaneous reduction of one or more fetuses in trichorionic triamniotic triplet pregnancies on time to delivery.

DESIGN:

Retrospective cohort study.

SETTING:

Academic medical center.

PATIENT(S):

IVF patients with trichorionic triamniotic triplets between January 1998 and December 2007.

INTERVENTION(S):

None.

MAIN OUTCOME MEASURE(S):

Gestational length at time of delivery.

RESULT(S):

Selective reduction to twins was used in 87 of the 153 (56.9%) triplet pregnancies that did not spontaneously reduce prior to <12 weeks, and was associated with longer gestation (13.9 days) with a fourfold greater likelihood of delivery at ≥ 34 weeks' gestation (odds ratio [OR], 4.3; 95% confidence interval [CI] = 2.2-8.6), compared with pregnancies not undergoing selective reduction. Compared with ongoing triplets, spontaneous reduction at <12 weeks' gestation (28 cases) was associated with longer gestation (13.7 days) and significantly greater likelihood delivering at or after 34 weeks' gestation (OR, 3.7; 95% CI, 1.4-9.9).

CONCLUSION(S):

Selective reduction of one fetus was used in 56.9% of patients in this population. Early spontaneous reduction (<12 weeks) and selective reduction to twins each conferred similar benefits by extending time to delivery and increasing the likelihood of delivery at or after 34 weeks' gestation.

[Indexed for MEDLINE]

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