Postoperative complications risk after multifetal pregnancy reduction

Аннотация

Objective: To study postoperative complications risk after multifetal pregnancy reduction (MFPR).

Полный текст

Methods: In 1995-99, 117 fetal reductions in 90 patients were performed. The term of pregnancy on the moment of operation was from 8w+ld to 13w+6d, in average 10 weeks+3 days. The method of fetal selection was based on fetal biometry data and Doppler investigation of fetoplacental system. 27 sets of quadruplets were reduced to twins and 63 sets of triplets - to twins. Under ultrasound guidance the punction of fetal thorax was performed in cardial area by means of transabdominal needle 22G and 1-2 ml of 4% KCl solution was injected. The asystolia was observed during first minute after solution injection.

Results: Multifetal pregnancy reduction was effective in all cases, no complications were registered. As in other invasive procedures during pregnancy the loss of fetuses continued development after MFPR during 2 weeks is directly connected with the procedure. The fetal loss within next 2 weeks is caused mostly by initial patient state before and during pregnancy. The fetal loss 4 weeks after the procedure is not associated with multifetal pregnancy reduction. In our investigation 2 cases of fetal loss (2,2%) were registered within 4 weeks after MFPR.

Conclusions: The results allow to consider that multifetal pregnancy reduction is relatively safe procedure for future pregnancy development.