Risks of miscarriage and early preterm birth in trichorionic triplet pregnancies with embryo reduction versus expectant management: new data and systematic review

Human Reproduction
A T PapageorghiouK H Nicolaides

Abstract

Triplet pregnancies are associated with a high risk of miscarriage and early preterm birth. It is uncertain if the outcome is improved by embryo reduction (ER). We examined trichorionic triplet pregnancies with three live fetuses at 10-14 weeks of gestation that were managed expectantly or by ER. The two groups were compared for the rates of miscarriage, defined as pregnancy loss before 24 weeks, and preterm delivery prior to 32 weeks. In addition, systematic searches were performed to identify studies comparing outcomes in expectant management versus ER in triplet pregnancies. We combined data from 365 pregnancies managed in our centre with those of five previous studies. In total there were 893 pregnancies. In the ER group (n=482) compared to the expectantly managed group (n=411), the rate of miscarriage was higher [8.1 versus 4.4%; relative risk (RR)=1.83, 95% confidence interval (CI)=1.08-3.16, P=0.036] and the rate of early preterm delivery was lower (10.4 versus 26.7%, RR=0.37, 95% CI=0.27-0.51, P<0.0001). It was calculated that seven (95% CI=5-9) reductions needed to be performed to prevent one early preterm delivery, while the number of reductions that would cause one miscarriage was 26 (95% CI=14-193). In trichorionic ...Continue Reading

References

Sep 1, 1987·Archives of Disease in Childhood·B J BottingA J Macfarlane
Jan 1, 1993·Journal of Perinatal Medicine·J H CheckB Schubert
Oct 1, 1993·American Journal of Obstetrics and Gynecology·G A MaconesR J Wapner
Nov 13, 1993·BMJ : British Medical Journal·B PettersonF Stanley
Oct 1, 1996·American Journal of Obstetrics and Gynecology·M Smith-LevitinZ Rosenwaks
Oct 23, 1997·British Journal of Obstetrics and Gynaecology·N J SebireK H Nicolaides
Oct 23, 1997·British Journal of Obstetrics and Gynaecology·N J SebireK H Nicolaides
May 18, 1999·American Journal of Obstetrics and Gynecology·Y YaronM I Evans
Aug 15, 2000·American Journal of Obstetrics and Gynecology·M P LeondiresR T Scott
Apr 17, 2003·Clinics in Perinatology·Mark I EvansRonald J Wapner
Aug 15, 2003·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Ola Didrik Saugstad
Jul 24, 2004·BJOG : an International Journal of Obstetrics and Gynaecology·Rebecca SimmonsNoreen Maconochie
Jul 29, 2004·Best Practice & Research. Clinical Obstetrics & Gynaecology·Mark I EvansDavid W Britt
Jul 29, 2004·Best Practice & Research. Clinical Obstetrics & Gynaecology·Isaac Blickstein
Dec 9, 2004·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·A GeipelU Germer

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Citations

Dec 9, 2010·Journal of Perinatal Medicine·Aris Antsaklis, Eleftherios Anastasakis
Dec 24, 2013·Best Practice & Research. Clinical Obstetrics & Gynaecology·Siladitya Bhattacharya, Mohan S Kamath
Feb 25, 2014·Archives of Gynecology and Obstetrics·Emre OkyayBulent Gulekli
Aug 13, 2015·BJOG : an International Journal of Obstetrics and Gynaecology·F D'AntonioA Khalil
Dec 24, 2011·Fertility and Sterility·UNKNOWN Practice Committee of American Society for Reproductive Medicine
Sep 25, 2010·Seminars in Fetal & Neonatal Medicine·R C Wimalasundera
Jul 18, 2008·Reproductive Biomedicine Online·Jan Gerris
Sep 10, 2014·The Australian & New Zealand Journal of Obstetrics & Gynaecology·Marzieh ShivaNarges Bagheri Lankarani
Oct 19, 2010·American Journal of Obstetrics and Gynecology·Teresa CoboEduard Gratacós
Sep 8, 2010·American Journal of Obstetrics and Gynecology·C Andrew CombsUNKNOWN Obstetrix Collaborative Research Network
Jul 9, 2011·American Journal of Obstetrics and Gynecology·George I PapaioannouKypros H Nicolaides
Oct 10, 2012·Fertility and Sterility·Anat Hershko-KlementArie Berkovitz
Mar 16, 2012·Prenatal Diagnosis·F Kuhn-BeckR Favre
Dec 1, 2007·Orvosi hetilap·Ervin HrubyZoltán Papp
Apr 19, 2007·Gynäkologisch-geburtshilfliche Rundschau·Elisabeth Krampl, Katharina Klein
Dec 26, 2018·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·J CuradoA Khalil
Jul 25, 2019·Obstetrics & Gynecology Science·Kyu-Sang KyeongCheong-Rae Roh
Nov 20, 2016·BJOG : an International Journal of Obstetrics and Gynaecology
Aug 20, 2021·Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'obstétrique Et Gynécologie Du Canada : JOGC·Jemimah Raffé-DevineZoe F Cairncross
Aug 31, 2021·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Chanchal SinghDeeksha Khurana
Nov 9, 2021·Acta Obstetricia Et Gynecologica Scandinavica·Ji Yeon LeeJong Kwan Jun

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