USA: Loss rates with multifetal pregnancy reduction

This study, published in the American Journal of Obstetrics and Gynecology, was undertaken to report on the outcome of multifetal pregnancy reduction in the most up-to-date largest single centre experience with this procedure.

The outcome was compared to the first 1000 cases performed at the same institution.

1000 consecutive cases of multifetal pregnancy reduction performed at the Mount Sinai Medical Center between the years 1999-2006 were identified. Pregnancy outcomes were retrieved from a large database as well as chart review. Differences in means and proportions were evaluated by analysis of variance, chi-square, Cochran-Armitage test for trend or 2-tailed Fisher exact test as appropriate.

Outcomes were available on 841 cases, for a follow-up rate of 84.1%; 95.2% of patients delivered after 24 weeks, for a complete loss rate of 4.7%. There was a significant trend toward decreasing loss rates with decreasing starting numbers. Mean gestational age at delivery was later, and birthweights greater, for reduction to singletons vs twins.

The authors concluded that loss rates after multifetal pregnancy reduction have remained stable at 4.7%. The lowest loss rate occurred in the patients reducing from twins to a singleton (2.1%). Reduction to a singleton was also associated with higher birthweights and lower rates of preterm deliveries.

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Mount Sinai School of Medicine, New York, NY, USA.

Contemporary outcomes with the latest 1000 cases of multifetal pregnancy reduction (MPR). Stone J, Ferrara L, Kamrath J, Getrajdman J, Berkowitz R, Moshier E, Eddleman K. American Journal of Obstetrics and Gynecology. 2008 Oct;199(4):406.e1-4.