Type of placentation as a criterion of fetal selection before multifetal pregnancy reduction

Abstract

Objective: to study the possibility of using the type of placentation as a criterion of fetal selection before multifetal pregnancy reduction (MFPR).

Full Text

Methods and results: Method of fetal selection before fetal number reduction in multiple pregnancy developed after assisted reproductive technology (ART) was based on estimation of presence of fetal chromosomal diseases ultrasound markers, fetal biometry & Doppler investigation of fetoplacental system. However, sometimes the obstetrical situation requires to find other fetal selection criteria before MFPR. In first case the reduction of diamniotic monochorial twins in quadruplet pregnancy after ART was performed. The diamniotic dichorial twins continued its development after procedure. In the second case the difigotic pregnancy was diagnosed after ART, it consisted of diamniotic monochorial twins & third fetus which was subjected to reduction. Such kind of selection is based on the risk of development of twin’s embolization syndrome in which the thromboplastic substance is transferred from dead fetus to alive one resulted in DIC syndrome and/or cerebral insults in fetus with consequent severe neurological outcomes.

Conclusions: So, the type of placentation in multiple pregnancy can be used as a criterion for fetal selection before multifetal pregnancy reduction in the purposes of decreasing the levels of perinatal morbidity and mortality.