Amer J Perinatol 2017; 34(14): 1417-1423
DOI: 10.1055/s-0037-1603969
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Multifetal Pregnancy Reduction of Trichorionic Triplet Gestations: What is the Benefit?

Nola Herlihy1, Mariam Naqvi1, 2, Julie Romero1, 2, Simi Gupta1, 2, Ana Monteagudo1, 2, Andrei Rebarber1, 2, Nathan S. Fox1, 2
  • 1Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
  • 2Maternal Fetal Medicine Associates, PLLC, New York, New York
Further Information

Publication History

04 March 2017

25 May 2017

Publication Date:
21 June 2017 (eFirst)

Abstract

Objective This study aims to determine the efficacy of multifetal pregnancy reduction (MFPR) in improving obstetrical outcomes for trichorionic triplet gestations.

Study Design Retrospective cohort study of patients with multiple gestations delivered by a single maternal-fetal medicine practice from 2005 to 2016. We compared patients with trichorionic triamniotic triplet gestations who underwent MFPR to those with an ongoing triplet pregnancy (TT), as well as primary dichorionic diamniotic twin gestations (DD). Logistic regression analysis was used to control for any differences at baseline.

Results There were 42 patients in the MFPR group, 43 women in the TT group, and 693 women in the DD group. Comparing MFPR to TT, the likelihood of preterm birth < 34 weeks was similar (31.0 vs. 39.5%, adjusted odds ratio [aOR]: 0.63, 95% confidence interval [CI]: 0.21, 1.87). There were no differences in gestational age at delivery, pregnancy loss < 24 weeks, or the likelihood of all, none, or at least two babies surviving to discharge. Mean birth weights were significantly higher and cesarean delivery rates lower for MFPR (2,128 vs. 1,836 g, p = 0.028 and 69 vs. 86%, aOR: 0.25, 95% CI: 0.06, 0.94) as compared with the TT group. MFPR had significantly worse outcomes than DD.

Conclusion In trichorionic triamniotic triplet pregnancies, our study suggests that obstetrical outcomes may not be as dramatically improved with MFPR as seen in older studies.