Talwar Pankaj, Sharma R K, Sandeep K, Sareen Shashi, Duggal B S
Classified Specialists (Obst and Gynae), ART Centre, AH (R & R), New Delhi - 10.
Consultant (Obst and Gynae), CH (SC), Pune.
Med J Armed Forces India. 2011 Jul;67(3):241-4. doi: 10.1016/S0377-1237(11)60050-6. Epub 2011 Aug 7.
The transvaginal ultrasound-guided embryo reduction technique is a feasible option for the prevention and management of the medical and obstetric risks associated with high-order multiple pregnancy resulting from assisted reproductive treatment.
Multifoetal pregnancy reduction was carried out in 51 in vitro fertilisation pregnancies (IVF) and one intrauterine quintuplet pregnancy resulting from intrauterine insemination (IUI) using transvaginal approach under ultrasonographic guidance.
Of the 52 embryo reduction procedures, 48 (92%) were performed between the seventh and eighth weeks of gestation, three between eighth and ninth weeks and one in the 10th week of gestation. Forty-nine patients (94%) underwent reduction from triplets to twins, two from quadruplet to twins, and one from quintuplet to twin pregnancy. The average time required for the embryo reduction was 5.0 ± 0.5 minutes per sac in early gestation (6th-9th weeks), increasing to 8.5 minutes per sac for later procedures, due to technical difficulties brought about by increased embryo size and mobility. All embryo reduction procedures were successfully performed in a single session.
Transvaginal ultrasound guided embryo reduction technique performed between seventh and eighth-weeks of gestation is an effective and safe procedure for embryo reduction.
经阴道超声引导下的减胎技术是预防和处理辅助生殖治疗导致的高阶多胎妊娠相关医学和产科风险的可行选择。
采用经阴道途径，在超声引导下对51例体外受精妊娠（IVF）和1例宫内人工授精（IUI）导致的宫内五胎妊娠进行多胎减胎。
在52例减胎手术中，48例（92%）在妊娠第7至8周进行，3例在第8至9周进行，1例在妊娠第10周进行。49例患者（94%）从三胎减为双胎，2例从四胎减为双胎，1例从五胎减为双胎妊娠。早期妊娠（第6至9周）减胎平均每个孕囊所需时间为5.0±0.5分钟，后期手术因胚胎大小和活动度增加带来技术困难，每个孕囊所需时间增至8.5分钟。所有减胎手术均在一次操作中成功完成。
妊娠第7至8周进行的经阴道超声引导下减胎技术是一种有效且安全的减胎方法。
