Shalev J, Frenkel Y, Goldenberg M, Shalev E, Lipitz S, Barkai G, Nebel L, Mashiach S
Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Fertil Steril. 1989 Sep;52(3):416-20. doi: 10.1016/s0015-0282(16)60910-x.
Selective fetal reduction was performed in the first trimester of pregnancy in 20 women with multifetal gestations after ovulation induction with human menopausal gonadotropin (hMG). In 10 women (group A) reduction was performed transabdominally, and in 10 women (group B) the transvaginal approach was used. The transvaginal technique achieved penetration of several gestational sacs without withdrawing the needle from the uterus. Fetal termination using either procedure occurred with intrafetal injection of potassium chloride. Six (60%, group A) and eight (80%, group B) patients delivered healthy newborns. One patient (group B) is at 30 weeks' gestation. Four (40%, group A) and one (10%, group B) aborted 1 day to 8 weeks after the procedure (1 septic abortion, each group). Our results suggest that transvaginal fetal reduction offers a better outcome, with minimal complications, to patients referred for selective continuation of pregnancy.
对20例使用人绝经期促性腺激素（hMG）诱导排卵后多胎妊娠的孕妇在妊娠早期进行了选择性减胎术。其中10例孕妇（A组）采用经腹减胎术，10例孕妇（B组）采用经阴道减胎术。经阴道技术在不将针从子宫中拔出的情况下穿透了多个妊娠囊。两种手术均通过向胎儿体内注射氯化钾来终止妊娠。A组6例（60%）和B组8例（80%）患者分娩出健康新生儿。1例患者（B组）妊娠30周。4例（40%，A组）和1例（10%，B组）在手术后1天至8周流产（每组各有1例感染性流产）。我们的结果表明，对于因选择性继续妊娠而转诊的患者，经阴道减胎术效果更佳，并发症最少。
