Transabdominal multifetal pregnancy reduction: report of 40 cases.

Forty patients with multiple gestations, all resulting from infertility treatment, underwent transabdominal multifetal pregnancy reduction at an average of 12 weeks' gestation. Twenty-three women with triplets, 13 with quadruplets, and four with quintuplets had their pregnancies reduced to twins, except for two (one reduced from five to three and one from three to one). Twenty-eight women have delivered and 12 have ongoing pregnancies; none of the 40 lost the entire pregnancy after the procedure. There was one neonatal death from prematurity, and one fetus died because of growth retardation. Ten (36%) delivered after 37 weeks' gestation, 16 (57%) between 33-36 weeks, and two (7%) before 33 weeks. No maternal complications directly related to the procedure were encountered. We conclude that selective termination is a safe procedure that may improve multifetal pregnancy outcome.