Pregnancy · Multiple Gestation

Selective reduction in multiple gestations: pregnancy outcome after transvaginal and transabdominal needle-guided procedures

Shalev J, Frenkel Y, Goldenberg M, Shalev E, Lipitz S, Barkai G, Nebel L, Mashiach S

Published September 1989 Fertility and Sterility, 52(3), 416-420
DOI 10.1016/s0015-0282(16)60910-x PMID 2776895

Abstract

Selective fetal reduction was performed in the first trimester of pregnancy in 20 women with multifetal gestations after ovulation induction with human menopausal gonadotropin (hMG). In 10 women (group A) reduction was performed transabdominally, and in 10 women (group B) the transvaginal approach was used. The transvaginal technique achieved penetration of several gestational sacs without withdrawing the needle from the uterus. Fetal termination using either procedure occurred with intrafetal injection of potassium chloride. Six (60%, group A) and eight (80%, group B) patients delivered healthy newborns. One patient (group B) is at 30 weeks' gestation. Four (40%, group A) and one (10%, group B) aborted 1 day to 8 weeks after the procedure (1 septic abortion, each group). Our results suggest that transvaginal fetal reduction offers a better outcome, with minimal complications, to patients referred for selective continuation of pregnancy.

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Pregnancy › Multiple Gestation › Multiple Birth Risks · Assisted Reproduction › Procedures and Protocols › Ovarian Stimulation · Birth and Delivery › Birth Outcomes › Maternal Morbidity
Josef Shalev, Yair Frenkel, Mordechai Goldenberg, Eliezer Shalev, Shlomo Lipitz, Gad Barkai, Laslo Nebel, Shlomo Mashiach
J Shalev, Y Frenkel, M Goldenberg, E Shalev, S Lipitz, G Barkai, L Nebel, S Mashiach
PMID 2776895 2776895 DOI 10.1016/s0015-0282(16)60910-x 10.1016/s0015-0282(16)60910-x Shalev et al. 1989, Shalev 1989