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Korean Journal of Obstetrics & Gynecology 2000;43(2):228-236.
Published online January 1, 2001.
Pregnancy Outcomes after Transvaginal Selective Fetal Reduction in Multifetal Pregnancy.
Seok Hyun Kim, Sang Soo Seo, Kyung Sil Lim, Byung Chul Jee, Chang Suk Suh, Young Min Choi, Jung Gu Kim, Shin Yong Moon, Jin Yong Lee
Abstract
OBJECTIVE
To evaluate the maternal and fetal outcomes after transvaginal selective fetal reduction(SFR) in multifetal pregnancy. MATERIALS AND METHODS: Transvaginal SFR using fetal intracardiac puncture with KCl injection and aspiration of amniotic fluid was performed in 58 multifetal pregnancies achieved after assisted reproductive technology(ART). After transvaginal SFR, 55 twin and 3 singleton pregnancies were evaluated and analyzed retrospectively with the medical records of mothers and babies. RESULTS: Of 58 cases, abortion within 4 weeks after SFR occurred in 1 case(1.7%). Miscarriage of all fetuses occurred in 8 cases(13.8%) from 4 weeks after SFR until 24 weeks of gestation. Perinatal death occurred in 8 newborns from 5 mothers due to extreme prematurity in 7 cases and anencephaly in 1 case. Take-home baby rate, that is, discharge with at least 1 healthy baby, was 77.6%(45/58). CONCLUSION: Transvaginal SFR is an acceptable and effective management option in the cases of excessive multifetal pregnancy after infertility treatment. The ultimate successful outcomes of reduced multifetal pregnancy may be enhanced by more extensive experience with SFR.
Key Words: Assisted reproductive technology(ART), Multifetal pregnancy, Selective fetal reduction(SFR), Transvaginal SFR, Pregnancy outcomes, Fetal outcomes


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