Vauthier-Brouzes D, Lefebvre G
Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
Fertil Steril. 1992 May;57(5):1012-6.
To evaluate efficiency and safety of a very early transvaginal selective reduction procedure in multifetal pregnancies.
Prospective study.
Obstetric and Gynecology Department, University of Paris VI.
Twenty-two patients with multifetal pregnancies: 14 triplets, 8 quadruplets, and 1 quintuplet.
Selective embryonic reduction was performed at 7 weeks of amenorrhea under general anesthesia by transvaginal embryo puncture and aspiration. Two embryos were left in place.
Pregnancy outcome (immediate or delayed complication, term of delivery, newborns) and psychological impact.
No complication occurred. The 22 patients now have delivered at 36.5 weeks of amenorrhea, on average giving birth to 44 neonates with no congenital malformation. If the procedure generates anxiety, it is nevertheless perceived as necessary for the successful outcome of the pregnancy.
Early mechanical transvaginal embryo reduction performed at 7 weeks of amenorrhea, leaving two embryos is, in our opinion, a simple and safe procedure with no affect on remaining fetuses. It is necessary when there are four or more embryos, and it should also be proposed for triplets. In these circumstances, patients saw reduction as a necessary procedure.
评估多胎妊娠极早期经阴道选择性减胎术的有效性和安全性。
前瞻性研究。
巴黎第六大学妇产科。
22例多胎妊娠患者，其中14例三胎妊娠、8例四胎妊娠和1例五胎妊娠。
在停经7周时，于全身麻醉下经阴道胚胎穿刺抽吸进行选择性胚胎减灭术，保留2个胚胎。
妊娠结局（即刻或延迟并发症、分娩孕周、新生儿情况）及心理影响。
未发生并发症。22例患者现已在停经36.5周时分娩，平均分娩44例新生儿，无先天性畸形。尽管该手术会引发焦虑，但患者仍认为其对妊娠成功结局是必要的。
我们认为，在停经7周时进行早期经阴道机械性胚胎减灭术，保留2个胚胎，是一种简单且安全的手术，对剩余胎儿无影响。当有4个或更多胚胎时该手术是必要的，三胎妊娠时也应考虑施行。在这种情况下，患者将减胎视为必要手术。
