Correlation analysis of adverse outcomes for the selective reduction of twin pregnancies

• Published in: BMC pregnancy and childbirth 2022-05, Vol.22 (1), p.417-417, Article 417
• Main Authors: Gao, Li, Xu, Qian-Qian, Wang, Shan, Xia, Yuan-Qing, Zhao, Xin-Rong, Wu, Yi, Hua, Ren-Yi, Sun, Jin-Ling, Wang, Yan-Lin
• Format: Article
• Language: English
• Subjects: Ablation; Adverse outcomes; Correlation analysis; Female; Gestational Age; Humans; Induced labor; Infant, Newborn; Miscarriage; Obstetrics; Potassium; Pregnancy; Pregnancy Outcome - epidemiology; Pregnancy, Twin; Premature birth; Premature Birth - epidemiology; Premature Birth - etiology; Retrospective Studies; Selective reduction; Stillbirth; Survival analysis; Transabdominal; Twin pregnancy; Twins; Twins, Dizygotic; Twins, Monozygotic
• ISSN: 1471-2393; 1471-2393
• DOI: 10.1186/s12884-022-04754-4

Due to the extensive development of assisted reproductive technology, the number of twin pregnancies has increased significantly over recent decades. Twin pregnancy is the most representative type of multiple pregnancies and is associated with high infant morbidity and mortality. Perinatal complications of twin pregnancy are also markedly increased compared with those of single pregnancy. Transabdominal selective reduction (SR) is a remedial intervention. This study aimed to research the adverse outcomes of transabdominal selective reduction of twin pregnancy and the correlation between the reduction week and pregnancy outcomes. The purpose of this study was to examine the adverse outcomes of the transabdominal selective reduction of twin pregnancy and the correlation between the reduction week and pregnancy outcomes. A retrospective cohort study of the transabdominal reduction of twin pregnancy was conducted in a single prenatal diagnosis medical centre from September 2012 to October 2020. According to chorionicity, women with twin pregnancies were divided into 2 groups: dichorionic (DC) twin pregnancies and monochorionic (MC) twin pregnancies. Women with DC twin pregnancies underwent potassium chloride reduction, and those with MC twin pregnancies underwent radiofrequency ablation (RFA). The reduction indications included pregnancy complications, foetal abnormalities, and maternal factors. The perinatal outcomes of different chorionic twins after reduction were analysed. Each foetus with an adverse outcome was included. The relative relationship between the reduction weeks and delivery weeks of twins was examined by correlation analysis. A total of 161 women were included in this study. A total of 112 women had DC twin pregnancies, and 49 women had MC twin pregnancies. Preterm delivery rates were significantly higher in the MC twin reduction group than in the DC twin reduction group prior to 37 weeks (53.1% vs. 29.5%, P = 0.004). The mean gestational age at delivery of the foetuses in the DC twin group that underwent SR was significantly older than that of those in the MC twin group that underwent SR (36.9 ± 4.0 vs. 33.5 ± 6.6 weeks, P = 0.001). The number of DC twins that underwent SR and were delivered after 37 weeks was obviously greater than that of the MC twins that underwent SR (70.5% vs. 46.9%, P = 0.004). The foetal survival rate was 95.5% in the DC twin reduction group and 77.6% in the MC twin reduction group. If the indication of TTTS was not i