Obstetric outcome after fetal reduction to singleton pregnancies

Objective To study the outcome after fetal reduction or selective termination to singleton pregnancies for various indications. Methods Fetal reduction or selective feticide to singleton pregnancies was performed in 80 multiple gestations (congenital malformations, 17 cases- high-risk obstetric conditions. 25 cases. or social/psychological indications, 38 cases). Results The overall pregnancv loss rate was MY,, however. pregnancy failure was significantly higher in selective reductions performed for preterm prelabor rupture or membranes (PPROM) (4/8) compared with monochorionic twin and bad obstetric history. Fetal reduction to singletons for psychological reasons resulted in a pregnancy wastage of 5.3% (2/38). Procedures performed at less than or equal to14 weeks showed a significantly lower fetal loss rate (2/61: 3.3%), a higher mean gestational age at delivery (38.3 +/- 2.2 weeks), and a decreased prematurity rate (pless than or equal to0.001). The number of reduced fetuses. prenatal diagnosis by chorionic villus sampling before the reduction and maternal age did not interfere with pregnancy outcome. Conclusion Fetal reduction to singleton pregnancies has a favorable outcome. especially when performed before 14 weeks of gestation. Copyright (C) 2002 John Wiley Sons, Ltd.