Department of Obstetrics and Gynecology, Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey.
Private Practice, Istanbul, Turkey.
Eur J Obstet Gynecol Reprod Biol. 2022 Jan;268:18-21. doi: 10.1016/j.ejogrb.2021.11.001. Epub 2021 Nov 9.
The management of multiple pregnancies is still a challenge. The aim of this study was to compare the outcome of triplet pregnancies managed expectantly or by multifetal pregnancy reduction to twins.
For this retrospective, comparative and monocentric study, the medical files of all women with triplets who admitted to our institution over a 13-year period were examined. Women requesting multifetal pregnancy reduction to have twins formed the study group, and women with triplets who wished to continue their pregnancies formed the control group. Main outcome measures were durations of pregnancies presented as number of weeks gestation, abortion rates, term and preterm birth rates, fetal loss and live birth rates.
During the study period, 171 women with triplets admitted to our institution. One hundred fifty one patients are included in this study. Forty-five women carrying triplets wished to continue their pregnancies and 106 women requested multifetal pregnancy reduction to have twins. Fetal reduction of triplets to twins was associated with a significantly lower incidence of birth before 34th gestational week and higher incidence of late preterm and term birth rates without changing live birth rates.
Multifetal pregnancy reduction of triplet pregnancies to twins resulted in a later gestational age at birth compared with the triplet gestations managed expectantly.
多胎妊娠的管理仍然是一个挑战。本研究的目的是比较期待治疗和多胎妊娠减胎术治疗三胎妊娠与双胎妊娠的结局。
本回顾性、对比性和单中心研究中，检查了 13 年来我院所有三胞胎孕妇的病历。要求多胎妊娠减胎为双胎妊娠的孕妇为研究组，希望继续妊娠的三胞胎孕妇为对照组。主要观察指标为妊娠时间（以孕周表示）、流产率、足月和早产率、胎儿丢失率和活产率。
研究期间，我院共收治 171 例三胞胎孕妇。本研究共纳入 151 例患者。45 例三胞胎孕妇希望继续妊娠，106 例孕妇要求多胎妊娠减胎为双胎。多胎妊娠减胎为双胎妊娠与 34 孕周前出生的发生率显著降低，晚期早产和足月出生的发生率升高，而活产率无变化。
与期待治疗的三胎妊娠相比，多胎妊娠减胎为双胎妊娠可使分娩时的胎龄延长。
