Rådestad A, Bui T H, Nygren K G
Department of Obstetrics and Gynecology, Karolinska sjukhuset, Stockholm, Sweden.
Acta Obstet Gynecol Scand. 1994 May;73(5):403-6. doi: 10.3109/00016349409006252.
All departments of Obstetrics and Gynecology, as well as all private clinics in Sweden offering assisted conception, were surveyed by means of a questionnaire to determine the utilization rate and outcome of multifetal pregnancy reduction (MFR) for the period 1 January 1986 to 30 June 1992. The response rae was 100%. Multifetal reduction was performed in 26 women, giving an average utilization rate of 1/7 multiple births of three or more for the entire period. Of the various techniques used, intracardiac or intrathoracic injection of a potassium chloride solution was predominant. The experience of each center with multifetal reductions varied between one and six procedures. In this series, the overall complete pregnancy loss was 27% (n = 7). In 73% (n = 19) of women the pregnancy continued to delivery. One fetus died in utero in the second trimester, one child died from a subtentorial hemorrhage perinatally, and one child had a malformation of the right foot and hand. It seems necessary to limit MFR to a few centers in Sweden in order to maintain and increase the experience of the operators involved, and to decrease the fetal loss rate associated with the procedure. However, the ultimate goal is to make these procedures unnecessary when methods of avoiding excessive ovulation are refined and by limiting the number of replaced embryos in IVF-treatment.
通过问卷调查的方式，对瑞典所有妇产科部门以及所有提供辅助受孕的私人诊所进行了调查，以确定1986年1月1日至1992年6月30日期间多胎妊娠减胎术（MFR）的使用率和结局。回复率为100%。26名女性接受了多胎减胎术，整个期间三胎及以上多胎妊娠的平均使用率为1/7。在使用的各种技术中，心内或胸腔内注射氯化钾溶液占主导地位。每个中心多胎减胎术的经验在1至6例手术之间不等。在这个系列中，总的完全妊娠丢失率为27%（n = 7）。73%（n = 19）的女性妊娠持续至分娩。1例胎儿在孕中期死于宫内，1例儿童围产期死于小脑下出血，1例儿童有右手和右脚畸形。为了保持并增加相关操作人员的经验，并降低与该手术相关的胎儿丢失率，在瑞典似乎有必要将多胎减胎术限制在少数几个中心进行。然而，最终目标是当避免过度排卵的方法得到完善，并通过限制体外受精治疗中移植胚胎的数量时，使这些手术不再必要。
