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International, Collaborative Experience of 1789 Patients Having Multifetal Pregnancy Reduction: A Plateauing of Risks and Outcomes

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Abstract

Objective

To develop the most up-to-date, complete data base of multifetal pregnancy reduction (MFPR) from cases, and to provide the best counseling for couples unth multifetal pregnancies.

Methods

From nine centers in five countries, 1789 completed MFPR cases were collected and outcomes evaluated. Pregnancy losses were defined as through 24 weeks and deliveries categorized in groups of 25–28, 29–32, 33–36, and 31 or more weeks.

Results

Overall, the pregnancy loss rate was 11.7% but varied from a low of 7.6% for triplets to twins and increased with each additional starting number to 22.9% for sextuplets or higher. Early premature deliveries (25–28 weeks) were 4.5% and varied with starting number. Loss rates by finishing number were highest for triplets and lowest for twins, but gestational age at deliver)’ was highest for singletons.

Conclusions

Multifetal pregnancy reduction has been shown to be a safe and effective method to improve outcome in multifetal pregnancies. Outcomes are worse with higher-order gestations and support the need for continued vigilance of fertility therapy.

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Authors and Affiliations

  1. Departments of Obstetrics and Gynecology, Molecular Medicine and Genetics, and Pathology, Wayne State University/Hutzel Hospital, 4707 St. Antoine Blvd., Detroit, Michigan, 48201, USA

    Mark I. Evans MD, Marc Dommergues MD, Ronald J. Wapner MD, James D. Goldberg MD, Lauren Lynch MD, Ivan E. Zador PhD, Robert J. Carpenter Jr MD, Ilan Timor-Tritsch MD, Bruno Brambati MD, Kypros H. Nicolaides MD, Yves Dumez MD, Anna Monteagudo MD, Mark P. Johnson MD, Mitchell S. Golbus MD, Lucia Tului PhD, Shawn M. Polak MS & Richard L. Berkowitz MD

  2. Departments of Obstetrics and Gynecology of the following: Maternite Port Royal, Paris, France

    Mark I. Evans MD, Marc Dommergues MD, Ronald J. Wapner MD, James D. Goldberg MD, Lauren Lynch MD, Ivan E. Zador PhD, Robert J. Carpenter Jr MD, Ilan Timor-Tritsch MD, Bruno Brambati MD, Kypros H. Nicolaides MD, Yves Dumez MD, Anna Monteagudo MD, Mark P. Johnson MD, Mitchell S. Golbus MD, Lucia Tului PhD, Shawn M. Polak MS & Richard L. Berkowitz MD

  3. Jefferson-Philadelphia, Philadelphia, Pennsylvania, USA

    Mark I. Evans MD, Marc Dommergues MD, Ronald J. Wapner MD, James D. Goldberg MD, Lauren Lynch MD, Ivan E. Zador PhD, Robert J. Carpenter Jr MD, Ilan Timor-Tritsch MD, Bruno Brambati MD, Kypros H. Nicolaides MD, Yves Dumez MD, Anna Monteagudo MD, Mark P. Johnson MD, Mitchell S. Golbus MD, Lucia Tului PhD, Shawn M. Polak MS & Richard L. Berkowitz MD

  4. U.C.S.F., San Francisco, California, USA

    Mark I. Evans MD, Marc Dommergues MD, Ronald J. Wapner MD, James D. Goldberg MD, Lauren Lynch MD, Ivan E. Zador PhD, Robert J. Carpenter Jr MD, Ilan Timor-Tritsch MD, Bruno Brambati MD, Kypros H. Nicolaides MD, Yves Dumez MD, Anna Monteagudo MD, Mark P. Johnson MD, Mitchell S. Golbus MD, Lucia Tului PhD, Shawn M. Polak MS & Richard L. Berkowitz MD

  5. Mt. Sinai, New York, USA

    Mark I. Evans MD, Marc Dommergues MD, Ronald J. Wapner MD, James D. Goldberg MD, Lauren Lynch MD, Ivan E. Zador PhD, Robert J. Carpenter Jr MD, Ilan Timor-Tritsch MD, Bruno Brambati MD, Kypros H. Nicolaides MD, Yves Dumez MD, Anna Monteagudo MD, Mark P. Johnson MD, Mitchell S. Golbus MD, Lucia Tului PhD, Shawn M. Polak MS & Richard L. Berkowitz MD

  6. St. Lukes, Houston, Texas, USA

    Mark I. Evans MD, Marc Dommergues MD, Ronald J. Wapner MD, James D. Goldberg MD, Lauren Lynch MD, Ivan E. Zador PhD, Robert J. Carpenter Jr MD, Ilan Timor-Tritsch MD, Bruno Brambati MD, Kypros H. Nicolaides MD, Yves Dumez MD, Anna Monteagudo MD, Mark P. Johnson MD, Mitchell S. Golbus MD, Lucia Tului PhD, Shawn M. Polak MS & Richard L. Berkowitz MD

  7. Columbia University, New York, USA

    Mark I. Evans MD, Marc Dommergues MD, Ronald J. Wapner MD, James D. Goldberg MD, Lauren Lynch MD, Ivan E. Zador PhD, Robert J. Carpenter Jr MD, Ilan Timor-Tritsch MD, Bruno Brambati MD, Kypros H. Nicolaides MD, Yves Dumez MD, Anna Monteagudo MD, Mark P. Johnson MD, Mitchell S. Golbus MD, Lucia Tului PhD, Shawn M. Polak MS & Richard L. Berkowitz MD

  8. University of Milan, Milan, Italy

    Mark I. Evans MD, Marc Dommergues MD, Ronald J. Wapner MD, James D. Goldberg MD, Lauren Lynch MD, Ivan E. Zador PhD, Robert J. Carpenter Jr MD, Ilan Timor-Tritsch MD, Bruno Brambati MD, Kypros H. Nicolaides MD, Yves Dumez MD, Anna Monteagudo MD, Mark P. Johnson MD, Mitchell S. Golbus MD, Lucia Tului PhD, Shawn M. Polak MS & Richard L. Berkowitz MD

  9. Kings College, London, UK

    Mark I. Evans MD, Marc Dommergues MD, Ronald J. Wapner MD, James D. Goldberg MD, Lauren Lynch MD, Ivan E. Zador PhD, Robert J. Carpenter Jr MD, Ilan Timor-Tritsch MD, Bruno Brambati MD, Kypros H. Nicolaides MD, Yves Dumez MD, Anna Monteagudo MD, Mark P. Johnson MD, Mitchell S. Golbus MD, Lucia Tului PhD, Shawn M. Polak MS & Richard L. Berkowitz MD

Authors
  1. Mark I. Evans MD
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  2. Marc Dommergues MD
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  3. Ronald J. Wapner MD
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  4. James D. Goldberg MD
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  5. Lauren Lynch MD
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  6. Ivan E. Zador PhD
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  7. Robert J. Carpenter Jr MD
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  8. Ilan Timor-Tritsch MD
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  9. Bruno Brambati MD
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  10. Kypros H. Nicolaides MD
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  11. Yves Dumez MD
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  12. Anna Monteagudo MD
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  13. Mark P. Johnson MD
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  14. Mitchell S. Golbus MD
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  15. Lucia Tului PhD
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  16. Shawn M. Polak MS
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  17. Richard L. Berkowitz MD
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Evans, M.I., Dommergues, M., Wapner, R.J. et al. International, Collaborative Experience of 1789 Patients Having Multifetal Pregnancy Reduction: A Plateauing of Risks and Outcomes. Reprod. Sci. 3, 23–26 (1996). https://doi.org/10.1016/1071-5576(95)00037-2

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  • DOI: https://doi.org/10.1016/1071-5576(95)00037-2

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