The purpose of this study was to evaluate fetal outcome and maternal complicat ions of multifetal pregnancy reduction to a single fetus or twins. To evaluate s afety and efficacy of transabdominal chorionic villus sam...The purpose of this study was to evaluate fetal outcome and maternal complicat ions of multifetal pregnancy reduction to a single fetus or twins. To evaluate s afety and efficacy of transabdominal chorionic villus sampling for karyotyping b efore fetal reduction. Four hundred twenty-four consecutive multiple pregnancie s were reduced to twins (255 pregnancies) or a single fetus (169 pregnancies) at 8 to 13 weeks of gestation after transabdominal chorionic villus sampling for f etal karyotyping. Fetal and maternal outcome were observed prospectively and com pared with control series of twin (147) and singleton (885)-pregnancies in whic h reduction procedures were not performed. Transabdominal chorionic villus sampl ing was performed successfully in 100%of the cases. The accuracy of karyotyping was 99.2%. The overall pregnancy loss rate after reduction was 3.3%. No diffe rences were observed between study and control series for severe prematurity, lo w birth weight, and neonatal deaths. Mean gestational age at delivery (35.2%vs 38.1%) and mean birth weight (2180 g vs 2873 g) were significantly lower; prete rm delivery (64%vs 11%), neonatal death (3.4%vs 0.6%), and maternal complica tions (42.8%vs 9.5%) were significantly higher when the reduction was to twins rather than in reduction to a single fetus. Pregnancy loss rate did not differ between study series. The overall rate of chromosomal abnormalities in the study series was higher (relative risk, 2.0) than in singleton control series. The ou tcome of multiple pregnancies that were reduced to a single fetus or twins was s imilar to that of nonreduced pregnancies; fetal and maternal complications were significantly lower in the series of pregnancies that were reduced to a single f etus. The safety and efficacy of transabdominal chorionic villus sampling and th e higher pregnancy rate of chromosomal abnormalities in multiple pregnancies imp ly that fetal karyotyping should be advised before fetal reduction.展开更多
前言妊娠期間的胎勢(posture of the foetus)及胎向(position of the foetus)是分娩期中胎勢胎向轉變的基礎,是助產及難產手術必須具備的基礎知識。關於妊娠期中的胎勢胎向的問題,早在1909年美國的獸醫產科學家W.L.Williams就已進行了研...前言妊娠期間的胎勢(posture of the foetus)及胎向(position of the foetus)是分娩期中胎勢胎向轉變的基礎,是助產及難產手術必須具備的基礎知識。關於妊娠期中的胎勢胎向的問題,早在1909年美國的獸醫產科學家W.L.Williams就已進行了研究,以後日本的黑澤亮助氏及佐藤繁雄氏,蘇聯的氏等獸醫產科學家們對此也都有所論述。展开更多
文摘The purpose of this study was to evaluate fetal outcome and maternal complicat ions of multifetal pregnancy reduction to a single fetus or twins. To evaluate s afety and efficacy of transabdominal chorionic villus sampling for karyotyping b efore fetal reduction. Four hundred twenty-four consecutive multiple pregnancie s were reduced to twins (255 pregnancies) or a single fetus (169 pregnancies) at 8 to 13 weeks of gestation after transabdominal chorionic villus sampling for f etal karyotyping. Fetal and maternal outcome were observed prospectively and com pared with control series of twin (147) and singleton (885)-pregnancies in whic h reduction procedures were not performed. Transabdominal chorionic villus sampl ing was performed successfully in 100%of the cases. The accuracy of karyotyping was 99.2%. The overall pregnancy loss rate after reduction was 3.3%. No diffe rences were observed between study and control series for severe prematurity, lo w birth weight, and neonatal deaths. Mean gestational age at delivery (35.2%vs 38.1%) and mean birth weight (2180 g vs 2873 g) were significantly lower; prete rm delivery (64%vs 11%), neonatal death (3.4%vs 0.6%), and maternal complica tions (42.8%vs 9.5%) were significantly higher when the reduction was to twins rather than in reduction to a single fetus. Pregnancy loss rate did not differ between study series. The overall rate of chromosomal abnormalities in the study series was higher (relative risk, 2.0) than in singleton control series. The ou tcome of multiple pregnancies that were reduced to a single fetus or twins was s imilar to that of nonreduced pregnancies; fetal and maternal complications were significantly lower in the series of pregnancies that were reduced to a single f etus. The safety and efficacy of transabdominal chorionic villus sampling and th e higher pregnancy rate of chromosomal abnormalities in multiple pregnancies imp ly that fetal karyotyping should be advised before fetal reduction.
文摘前言妊娠期間的胎勢(posture of the foetus)及胎向(position of the foetus)是分娩期中胎勢胎向轉變的基礎,是助產及難產手術必須具備的基礎知識。關於妊娠期中的胎勢胎向的問題,早在1909年美國的獸醫產科學家W.L.Williams就已進行了研究,以後日本的黑澤亮助氏及佐藤繁雄氏,蘇聯的氏等獸醫產科學家們對此也都有所論述。
