Objective:To assess the perinatal and developmental outcomes of assisted reproductive technologies(ART) children born after multifetal pregnancy reduction(MPR). Methods:Twenty-four ART children born after MPR were com...Objective:To assess the perinatal and developmental outcomes of assisted reproductive technologies(ART) children born after multifetal pregnancy reduction(MPR). Methods:Twenty-four ART children born after MPR were compared to 9 triplets without MPR,and 24 matched IVF children without MPR and 24 naturally conceived.Mental and psychological development was assessed by Bayley Scales.of Infant.The outcomes compared included perinatal characteristics,body mass index(BMI), mental development index(MDI) and psychomotor development index(PDI). Results:MPR singletons/twins had better neonatal outcomes than non-MPR triplets.Moreover,PDI of the MPR singletons/twins was significantly higher than that of the non-MPR triplets.There were no significantly difference in perinatal characteristics,BMI,MDI and PDI among 24 MPR children,24 matched IVF children without MPR and 24 matched naturally conceived children. Conclusion:Multifetal pregnancy reduction could improve perinatal outcomes and would not affect physical, mental and psychomotor development for children born after it.展开更多
This was the first report of multifetal pregnancy reduction （MFPR） with mono- chorionic triplet pregnancy following ICSI and the transfer of frozen-thawed embryos. A 30-year-old woman who had undergone ICSI and the ...This was the first report of multifetal pregnancy reduction （MFPR） with mono- chorionic triplet pregnancy following ICSI and the transfer of frozen-thawed embryos. A 30-year-old woman who had undergone ICSI and the transfer of frozen-thawed embryos subsequently developed monochorionic triplet pregnancy. She did a multifetal pregnancy reduction to remove one embryo limb from the fetal sac and remained a singleton pregnancy after pregnancy reduction. At last she delivered a healthy baby girl at 40 weeks of gestation. In conclusions, an early stage fetal reduction, selection of the appropriate reduction week, and the expertise of a highly experienced doctor using ultrasound can ensure a wonderful pregnancy outcome in monozygotic multiple pregnancies.展开更多
Anencephaly is a frequent and easily diagnosed condition affecting twin pregnancies with higher incidence than singletons. Discordance for anencephaly in twins raises management dilemmas about the best approach to the...Anencephaly is a frequent and easily diagnosed condition affecting twin pregnancies with higher incidence than singletons. Discordance for anencephaly in twins raises management dilemmas about the best approach to the situation. The authors report a successful case of a 33 years old woman who had a dichorionic twin pregnancy resulting from ICSI, with discordance for anencephaly. Diagnosis was performed at 13 weeks during first trimester ultrasound screening. A selective feticide with intrathoracic injection of KCl at 13 + 2 weeks was performed with no complications. The normal fetus proceeded with an uneventful pregnancy with spontaneous vaginal delivery at 40 weeks, weighting 3110 g. Management of twin pregnancies discordant for fetal anencephaly is far from being consensual. Two options are considered: selective feticide or expectant management, with serial ultrasound surveillance. In the latter option, amniodrainage or selective feticide may become options if polyhydramnios develops later in pregnancy. Therapeutic strategy requires an individual approach considering chorionicity, gestational age and all the risks of miscarriage, preterm labor and fetal demise to which these pregnancies are particularly exposed.展开更多
文摘Objective:To assess the perinatal and developmental outcomes of assisted reproductive technologies(ART) children born after multifetal pregnancy reduction(MPR). Methods:Twenty-four ART children born after MPR were compared to 9 triplets without MPR,and 24 matched IVF children without MPR and 24 naturally conceived.Mental and psychological development was assessed by Bayley Scales.of Infant.The outcomes compared included perinatal characteristics,body mass index(BMI), mental development index(MDI) and psychomotor development index(PDI). Results:MPR singletons/twins had better neonatal outcomes than non-MPR triplets.Moreover,PDI of the MPR singletons/twins was significantly higher than that of the non-MPR triplets.There were no significantly difference in perinatal characteristics,BMI,MDI and PDI among 24 MPR children,24 matched IVF children without MPR and 24 matched naturally conceived children. Conclusion:Multifetal pregnancy reduction could improve perinatal outcomes and would not affect physical, mental and psychomotor development for children born after it.
文摘This was the first report of multifetal pregnancy reduction （MFPR） with mono- chorionic triplet pregnancy following ICSI and the transfer of frozen-thawed embryos. A 30-year-old woman who had undergone ICSI and the transfer of frozen-thawed embryos subsequently developed monochorionic triplet pregnancy. She did a multifetal pregnancy reduction to remove one embryo limb from the fetal sac and remained a singleton pregnancy after pregnancy reduction. At last she delivered a healthy baby girl at 40 weeks of gestation. In conclusions, an early stage fetal reduction, selection of the appropriate reduction week, and the expertise of a highly experienced doctor using ultrasound can ensure a wonderful pregnancy outcome in monozygotic multiple pregnancies.
文摘Anencephaly is a frequent and easily diagnosed condition affecting twin pregnancies with higher incidence than singletons. Discordance for anencephaly in twins raises management dilemmas about the best approach to the situation. The authors report a successful case of a 33 years old woman who had a dichorionic twin pregnancy resulting from ICSI, with discordance for anencephaly. Diagnosis was performed at 13 weeks during first trimester ultrasound screening. A selective feticide with intrathoracic injection of KCl at 13 + 2 weeks was performed with no complications. The normal fetus proceeded with an uneventful pregnancy with spontaneous vaginal delivery at 40 weeks, weighting 3110 g. Management of twin pregnancies discordant for fetal anencephaly is far from being consensual. Two options are considered: selective feticide or expectant management, with serial ultrasound surveillance. In the latter option, amniodrainage or selective feticide may become options if polyhydramnios develops later in pregnancy. Therapeutic strategy requires an individual approach considering chorionicity, gestational age and all the risks of miscarriage, preterm labor and fetal demise to which these pregnancies are particularly exposed.
