J Obstet Gynaecol Res. 2025 Oct;51(10):e70072. doi: 10.1111/jog.70072.
ABSTRACT
AIM: This study aimed to establish the safety of multifetal pregnancy reduction (MFPR) and examine its complications, patient background, and psychological impact.
METHODS: This single-center, single-arm, prospective intervention study included 10 women who were treated at our institution between April and December 2024. The indications were triplet or higher-order multiple pregnancies, as well as twin pregnancies with serious maternal complications. Procedures were performed between 11 and 13 gestational weeks, and the patients were observed for up to 1 week postoperatively. The primary outcome was the completion ratio at hospital discharge, whereas the secondary outcomes were the survival rate of non-targeted fetuses, the number of adverse events, and the psychological evaluation of the patients at 1 week postoperatively.
RESULTS: Among the 10 patients, one carried twins, seven carried triplets, and two carried quadruplets; half had received ovulation-induction treatment. The procedure completion rate at discharge was 100%, although one patient required reoperation. The survival rate of non-targeted fetuses was 89.5% (17/19), and adverse events included vaginal bleeding and complete miscarriage. Maternal state-anxiety scores decreased significantly postprocedure, whereas depression scores remained elevated both before and after the procedure.
CONCLUSIONS: The completion rate of MFPR using echo-guided transabdominal potassium chloride infusion was high, ensuring short-term maternal safety. Although no serious adverse event other than one case of total miscarriage was observed, a long-term safety evaluation is warranted. Moreover, the emotional burden on patients is high before and after the procedure, necessitating the importance of long-term support.
PMID:41031976 | DOI:10.1111/jog.70072
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