Safety of Ultrasound-guided Multifetal Pregnancy Reduction in the Second Trimester

Purpose To evaluate the safety and feasibility of transabdominal ultrasound guided multifetal pregnancy reduction performed in the second trimester. Materials and Methods Forty-three women receiving embryo implantation were divided into two groups according to whether they have received multifetal pregnancy reduction including 16 in the reduction group in the second trimester to reduce multiple fetuses to twins, and 27 with twin pregnancy and no reduction. The pregnancy outcome was compared. Results In the reduction group, 1 patient had miscarriage because of intrauterine infection; 1 patient lost one of the retained fetuses in two days after reduction and delivered the remaining fetus. In the other 14 cases, 8 delivered and 6 were still in pregnancy. This group had 17 newborns, all without neonatal death or birth defects. In the non-reduction group, there was 1 spontaneous abortion. In 2 patients, 1 of the twin embryos stopped development. 1 case had a spontaneous abortion, the other 24 cases delivered uneventfully. There were 50 newborns in this group with 3 birth defects and no neonatal death. There was no statistically significant difference in gestational age at delivery, birth weight, and the incidence of maternal and neonate complications(P0.05). Conclusion Multifetal reduction improves pregnancy outcomes, similar to non-reduction twin pregnancy. It is safe and feasible to perform multifetal pregnancy reduction in the second trimester.