Selective Fetal Reduction; Procedurel Factors Associated with Adverse Pregnancy Outcomes

Authors : Ömer Gökhan Eyisoy, Ümit Taşdemir, Mucize Eriç Özdemir, Murad Gezer, Oya Demirci

Pages : 50-55

View : 21 | Download : 57

Publication Date : 2025-03-15

Article Type : Research Paper

Abstract :Introduction: The aim of this study was to investigate the factors associated with selective fetal reduction (SFR) procedures that result in adverse pregnancy outcomes. Methods: The study cohort comprises all multiple pregnancies that underwent SFR during the period of six years. The SFR procedure has been performed for two main indications: first, in cases of fetal anomaly; and secondly, electively to reduce the number of fetuses in triplet and higher-order pregnancies. Preterm birth or preterm premature rupture of the membranes prior to 34 weeks of gestation, placental abruption, pregnancy loss before 24 weeks of gestation, and intrauterine fetal death defined as adverse pregnancy outcomes. Procedural factors associated with adverse pregnancy outcomes were evaluated. Results: A total of 39 SFR procedures were performed on 33 multiple pregnancies, with 31 resulting in live birth. A higher rate of adverse pregnancy outcomes was observed in pregnancies that underwent elective SFR, more than one procedure , were having triplets or higher-order pregnancies prior to the procedure, or were having twin or higher-order pregnancies post-procedure. Elective SFR procedures and multiple procedures have been demonstrated to be associated with an 8-fold and a 13.3-fold increased risk of adverse pregnancy outcomes. The risk ratio of triplet or higher-order pregnancies prior to the procedure and twin or higher-order pregnancies post-procedure was found to be 6.5 and 5.8, respectively, for adverse pregnancy outcomes. Conclusions: Instead of considering SFR as the first option in the management of higher order pregnancies, it is recommended that assisted reproductive technologies be used in a way that does not lead to high-order pregnancies. In cases where the prevention of a higher order pregnancy has not been possible, SFR should be considered in terms of its risks and benefits as a method of reducing adverse pregnancy outcomes.
Keywords : Seçici fetal redüksiyon, multifetal gebelik, yüksek dereceli çoğul gebelik, multifetal gebelik redüksiyonu, perinatal sonuçlar