Pregnancy outcome following fetal reduction from dichorionic
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The procedure for the fetal reduction was performed transabdominally by intracardiac injection of potassium chloride using a 20-Gauge needle until asystole was obtained.
There are still some controversies regarding the risks and benefits of fetal reduction from twins to singletons. The study aimed to evaluate if fetal reduction from twins to singleton improves pregnancy outcomes.

Ninety-eight reduced pregnancies were compared with 222 ongoing twins. Preterm birth less than 37 gestational weeks was significantly lower in the reduced group compared to the ongoing twins’ group. A multivariate analysis, controlling for parity and mode of conception, demonstrated that fetal reduction independently and significantly reduced the risk for prematurity. Subgroup analysis, similarly adjusted demonstrated lower rates of preterm delivery in those undergoing elective reduction, the reduction due to fetal anomalies, and 1st-trimester reduction all compared to ongoing twins. A Kaplan-Meier survival curve showed a significant proportion of non-delivered women at each gestational week in the reduced group compared to non-reduced twins, after 29 gestational weeks.

Fetal reduction from twins to a singleton pregnancy reduces the risk of preterm birth prior to 37 gestational weeks, but not for more severe maternal and perinatal complications. Be that as it may, fetal reduction from twins to singleton should at least be discussed with the expecting couple as an available management option for them to consider, with the balance between risks and benefits, with the attributed evidence, clearly and simply manifested.

Source:https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-020-03076-7
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