Itskovitz-Eldor J, Drugan A, Levron J, Thaler I, Brandes J M
Department of Obstetrics and Gynecology, Rambam Medical Center, Haifa, Israel.
Fertil Steril. 1992 Aug;58(2):351-5. doi: 10.1016/s0015-0282(16)55231-5.
To evaluate pregnancy outcome after transvaginal selective embryo aspiration and to compare the results with those reported previously with other techniques for selective abortion.
Retrospective case series.
University-based in vitro fertilization (IVF) program.
Nineteen women with multiple pregnancy who conceived after ovulation induction or IVF/gamete intrafallopian transfer.
Transvaginal ultrasound-guided aspiration of the embryo(s) was performed at 7 to 8 weeks of gestation.
Early and late complications related to the procedure, outcome of pregnancy, and birth weight.
In 18 cases, the initial number of embryos (3 to 7) was reduced to two. In 1 case, the number of embryos was reduced from 4 to 3. None of the remaining fetuses vanished after the procedure. One patient delivered at 25 weeks and all other patients delivered healthy, viable infants (a pregnancy loss rate of 5.3%).
Transvaginal embryo aspiration in early gestation appears to be a simple and relatively safe procedure for selective termination in patients with high-order multiple pregnancy. The cumulative loss rate of selective termination procedures previously reported by others is three times higher than the loss encountered in our series. This earlier procedure may be more acceptable to patients from emotional and religious points of view.
评估经阴道选择性胚胎抽吸术后的妊娠结局，并将结果与先前报道的其他选择性流产技术的结果进行比较。
回顾性病例系列。
基于大学的体外受精（IVF）项目。
19名在促排卵或IVF/配子输卵管内移植后受孕的多胎妊娠女性。
在妊娠7至8周时经阴道超声引导下抽吸胚胎。
与手术相关的早期和晚期并发症、妊娠结局及出生体重。
18例中，初始胚胎数（3至7个）减至2个。1例中，胚胎数从4个减至3个。术后其余胎儿均未消失。1例患者在25周分娩，其他所有患者均分娩出健康、存活的婴儿（妊娠丢失率为5.3%）。
妊娠早期经阴道胚胎抽吸术对于高阶多胎妊娠患者的选择性终止似乎是一种简单且相对安全的手术。其他人先前报道的选择性终止手术的累积丢失率比我们系列中遇到的丢失率高三倍。从情感和宗教角度来看，这种早期手术可能更容易被患者接受。
