Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK.
Fetal Diagn Ther. 2013;34(4):199-205. doi: 10.1159/000356170. Epub 2013 Nov 2.
To compare the outcome of trichorionic triplet (TCT) and dichorionic triplet (DCT) pregnancies managed expectantly and those with embryo reduction (ER) at 10-14 weeks to twins or singletons.
This was a retrospective study of triplet pregnancies with 3 live fetuses managed expectantly or by ER. Data were combined with the results of previous studies that used similar entry criteria and outcome measures. The management options were compared for rates of miscarriage and preterm birth <33 weeks.
In TCTs managed expectantly (n = 358), the rates of miscarriage and preterm birth were 3.1 and 35.1%. Compared to the expectantly managed TCTs, the rate of miscarriage was higher and preterm birth lower in TCTs with ER to 2 fetuses (n = 833, 7.3 and 13.1%, respectively) and TCTs with ER to 1 fetus (n = 78, 11.5 and 8.7%). In DCTs managed expectantly (n = 136), the rates of miscarriage and preterm birth were 8.8 and 46.0%. In DCTs with ER to 2 fetuses (n = 15) or ER to 1 fetus (n = 42), there was a non-significant increase in miscarriage (13.3 and 16.7%, respectively) and decrease in preterm birth (23.1 and 8%, respectively).
In TCT and DCT pregnancies, ER increases the rate of miscarriage but reduces the rate of preterm birth.
比较 10-14 周时期待治疗和胚胎减灭术（ER）治疗的三绒毛膜三胎（TCT）和二绒毛膜三胎（DCT）妊娠的结局，以了解其与双胎或单胎妊娠的差异。
本研究回顾性分析了 3 个活胎的三胎妊娠，这些妊娠分别接受期待治疗或 ER 治疗。数据与使用类似纳入标准和结局测量方法的先前研究结果相结合。比较了不同治疗方法的流产率和早产率（<33 周）。
在期待治疗的 TCT 中（n=358），流产率和早产率分别为 3.1%和 35.1%。与期待治疗的 TCT 相比，ER 至 2 个胎儿（n=833，分别为 7.3%和 13.1%）和 ER 至 1 个胎儿（n=78，分别为 11.5%和 8.7%）的 TCT 流产率更高，早产率更低。在期待治疗的 DCT 中（n=136），流产率和早产率分别为 8.8%和 46.0%。在 ER 至 2 个胎儿（n=15）或 ER 至 1 个胎儿（n=42）的 DCT 中，流产率分别增加（分别为 13.3%和 16.7%），早产率分别降低（分别为 23.1%和 8%），但差异无统计学意义。
在 TCT 和 DCT 妊娠中，ER 增加了流产率，但降低了早产率。
