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Journal of the Society for Gynecologic Investigation
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*High Risk Pregnancy
*Pregnancy Loss
*Premature Babies
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International, Collaborative Experience of 1789 Patients Having Multifetal Pregnancy Reduction: A Plateauing of Risks and Outcomes

Mark I. Evans, MD

Departments of Obstetrics and Gynecology, Molecular Medicine and Genetics, and Pathology, Hutzel Hospital/Wayne State University, Detroit, Michigan, and Departments of obstetrics and Gynecology of the following: Maternite Port Royal. Paris, France;Jefferson-Philadelphia, Philadelphia, Pennsylvania, U.C.S.F., San Francisco, California: Mt. Sinai, New York, St. Lukes, Houston, Texas; Columbia University, New York; University of Milan, Milan, Italy; and Kings College, London, United Kingdom; Departments of Obstetrics and Gynecology, Wayne State University/Hutzel Hospital, 4707 st Antoine Blvd., Detroit, MI 48201

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

Departments of Obstetrics and Gynecology, Molecular Medicine and Genetics, and Pathology, Hutzel Hospital/Wayne State University, Detroit, Michigan, and Departments of obstetrics and Gynecology of the following: Maternite Port Royal. Paris, France;Jefferson-Philadelphia, Philadelphia, Pennsylvania, U.C.S.F., San Francisco, California: Mt. Sinai, New York, St. Lukes, Houston, Texas; Columbia University, New York; University of Milan, Milan, Italy; and Kings College, London, United Kingdom

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 with 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 37 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 delivery 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.

Key Words: Multifetal pregnancy reduction • MFPR • prematurity • multiple gestation • infertility therapy • assisted reproductive techniques

Journal of the Society for Gynecologic Investigation, Vol. 3, No. 1, 23-26 (1996)
DOI: 10.1177/107155769600300106
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