The influence of multifetal pregnancy embrioreduction in high-risk pregnancies: Clinical management and outcome

Introduction: To decrease the risks associated with triplets pregnancies MFPR is preformed. The most frequently applied method is through ultrasound guided transabdominal injection of potassium chloride into the fetal heart or chest cavity at 11-14 weeks of gestation. Aim: The main objective of this study was to evaluate perinatal outcomes in triplet pregnancies after transabdominal MFPR as compared with ongoing triplet pregnancies and twin pregnancies. Material and methods: In this retrospective study, all women with trichorionic triplet pregnancies undergoing MFPR to a twin pregnancy, women with an ongoing trichorionic triplet pregnancy and with those with a primary dichorionic twin pregnancy were included. Results: Median gestation age at delivery was 35.6 ( interquartile range [IQR], 32.8-37 weeks) for triplets reduced to twins, 32.8 weeks (IQR, 27.6-34.7 weeks) for ongoing triplets, and 37 weeks ( IQR, 35.1-38.3 weeks) for primary twins (p <0.01 difference between all groups). There were 7 women in the reduction group (12.28%) vs 10 (19.6%) in the ongoing triplet group, whi and 4 (6.66%) in the primary twin group in whom not a single fetus survived. Preterm delivery before 32 weeks of gestation occurred less in the reduction group compared with the ongoing triplets (12 [20.9%] vs 18 [35.29%] ), but still more often than in primary twins - 7 (11.66%). Conclusion: Multifetal pregnancy reduction (MFPR) seems to be associated with a decreased risk of pregnancy loss both before 24 and 32 weeks of gestation in women with trichorionic triplet reduction.