Liu Yaqiong, Shen Yan, Zhang Hong, Tang Yi, Lu Guangxiu, Lin Ge, Gong Fei
Institute of Reproductive and Stem Cell Engineering, School of Basic Medicine, Central South University, China; Key Laboratory of Reproductive and Stem Cell Engineering, Ministry of Health, China.
Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China.
Taiwan J Obstet Gynecol. 2019 Jan;58(1):133-138. doi: 10.1016/j.tjog.2018.11.025.
To observe the pregnancy and perinatal outcomes of trichorionic triplet (TCT) and dichorionic triplet (DCT) pregnancies with or without multifetal pregnancy reduction (MFPR).
This was a retrospective study of 732 TCT and 118 DCT pregnancies after IVF/ICSI cycles between October 1999 and May 2014 at the Reproductive & Genetic Hospital of CITIC-Xiangya. The TCT and DCT groups were subdivided into three subgroups: MFPR to single fetus group, MFPR to twins group and expectant group. Pregnancy and perinatal outcomes were compared between different subgroups.
The resulting subgroups were TCT-Expectant (n = 40), TCT to twin (n = 610), TCT to single (n = 22), DCT-Expectant (n = 17), DCT to twin (n = 50), and DCT to single (n = 22). The groups with MFPR had the better pregnancy and perinatal outcomes. Meanwhile, the significantly higher abortion rates but lower live birth and take home baby rates were found in TCT-Expectant group and DCT-Expectant group (all P < 0.05). Besides, the abortion rate of DCT-Expectant group was much higher than TCT-Expectant group (41% verse 15%, P = 0.032). As for the perinatal outcomes, retaining single fetus group showed the advantage of higher birth weight, and elder gestational age in both DCT and TCT pregnancies (all P < 0.05).
For DCT and TCT pregnancies, MFPR application could reduce the miscarriage rate, while improving live birth and take home baby rates compared to the expectant groups. Especially, when reduced to a single fetus, MFPR could provide the better perinatal outcomes.
观察接受或未接受多胎妊娠减胎术（MFPR）的三绒毛膜三胎妊娠（TCT）和二绒毛膜三胎妊娠（DCT）的妊娠及围产期结局。
这是一项对1999年10月至2014年5月在中信湘雅生殖与遗传专科医院进行体外受精/卵胞浆内单精子注射（IVF/ICSI）周期后的732例TCT妊娠和118例DCT妊娠的回顾性研究。TCT组和DCT组又细分为三个亚组：减胎至单胎组、减胎至双胎组和期待治疗组。比较不同亚组之间的妊娠及围产期结局。
最终的亚组为TCT-期待治疗组（n = 40）、TCT减至双胎组（n = 610）、TCT减至单胎组（n = 22）、DCT-期待治疗组（n = 17）、DCT减至双胎组（n = 50）和DCT减至单胎组（n = 22）。接受MFPR的组妊娠及围产期结局更好。同时，TCT-期待治疗组和DCT-期待治疗组的流产率显著更高，但活产率和抱婴回家率更低（均P < 0.05）。此外，DCT-期待治疗组的流产率远高于TCT-期待治疗组（41%对15%，P = 0.032）。至于围产期结局，在DCT和TCT妊娠中，保留单胎组均显示出出生体重更高、孕周更大的优势（均P < 0.05）。
对于DCT和TCT妊娠，应用MFPR可降低流产率，同时与期待治疗组相比提高活产率和抱婴回家率。特别是，当减胎至单胎时，MFPR可提供更好的围产期结局。
