Cetin Arslan Hale, Arslan Kadir, Arslanoglu Tugce, Aydin Alev Atis
Department of Gynecology and Obstetrics, University of Health Sciences, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey.
Department of Anesthesiology and Reanimation, University of Health Sciences, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey.
Medicine (Baltimore). 2025 Sep 19;104(38):e44500. doi: 10.1097/MD.0000000000044500.
The increased use of assisted reproductive technologies (ART) has led to an increase in the frequency of multiple pregnancies. Multiple pregnancies are associated with higher maternal and fetal morbidity compared to singleton pregnancies. Multifetal pregnancy reduction (MFPR) can be performed to reduce these risks. This study aimed to compare the maternal and perinatal outcomes of triplet pregnancies undergoing MFPR with those followed without intervention. This retrospective cohort study was conducted in a tertiary obstetrics and gynecology clinic over 10 years (January 2014-January 2024). All triplet pregnancies received counseling regarding MFPR. Pregnancies reduced from triplets to twins constituted the MFPR group, while those followed without intervention constituted the conservative management group. Demographic data, obstetric history, and pregnancy outcomes were compared using appropriate statistical tests. A total of 187 triplet pregnancies (MFPR, n = 47; conservative management, n = 140) were examined. No significant differences were found between the groups in terms of maternal age, parity, history of miscarriage or preterm birth (P > .05). The gestational age at delivery was higher in the MFPR (35.2 vs 32.2 wk, P = .003). In triplet pregnancies, conservative treatment was an independent risk factor for delivery at <34 weeks (OR 2.4), cesarean delivery (OR 3.4), and need for NICU (OR 10.6) (all P < .05). Neonatal mortality was 5% in the conservative management and not in the MFPR. The MFPR procedure of triplets can significantly prolong gestational age, reduce the need for NICU, and improve perinatal prognosis. Because it provides these benefits without increasing maternal complications, MFPR should be offered as an option to patients and their families in the first trimester.
辅助生殖技术（ART）使用的增加导致多胎妊娠的频率上升。与单胎妊娠相比，多胎妊娠与更高的孕产妇和胎儿发病率相关。可以进行多胎妊娠减胎术（MFPR）以降低这些风险。本研究旨在比较接受MFPR的三胎妊娠与未经干预的三胎妊娠的孕产妇和围产期结局。这项回顾性队列研究在一家三级妇产科诊所进行，为期10年（2014年1月至2024年1月）。所有三胎妊娠均接受了关于MFPR的咨询。从三胎减为双胎的妊娠构成MFPR组，而未经干预的妊娠构成保守治疗组。使用适当的统计检验比较人口统计学数据、产科病史和妊娠结局。共检查了187例三胎妊娠（MFPR组，n = 47；保守治疗组，n = 140）。两组在产妇年龄、产次、流产或早产史方面无显著差异（P > 0.05）。MFPR组的分娩孕周更高（35.2周对32.2周，P = 0.003）。在三胎妊娠中，保守治疗是孕周<34周分娩（OR 2.4）、剖宫产（OR 3.4）和入住新生儿重症监护病房（NICU）需求（OR 10.6）的独立危险因素（所有P < 0.05）。保守治疗组的新生儿死亡率为5%，MFPR组无新生儿死亡。三胎的MFPR手术可显著延长孕周，减少入住NICU的需求，并改善围产期预后。由于它在不增加孕产妇并发症的情况下提供这些益处，MFPR应在孕早期作为一种选择提供给患者及其家属。
