Clinical analysis of 52 cases of vaginal ultrasound-guided fetal reduction of multiple pregnancies

Objective To explore the clinical application of selective fetal reduction guided by transvaginal ultrasound in multiple pregnancies. Methods A retrospective analysis was performed on 52 cases of multiple pregnancies within 10 weeks from January 2013 to December 2018 at the Reproduction Medical Center of our hospital. All patients underwent selective reduction under the guidance of transvaginal ultrasound. After operation, they were divided into either a single-fetus group or a multiple-fetus group. In addition, 82 cases of single and twin pregnancies within 10 weeks after treatment were randomly selected as a single-fetus control group and multiple-fetus control group, respectively. Fetal birth weight, low birth weight rate, premature birth rate, and late abortion rate, as well as the related complications during pregnancy, including gestational diabetes mellitus, gestational hypertension, postpartum hemorrhage, and premature rupture of membranes, were recorded. The four groups of subjects were compared for the above indicators. Results The successful rate of fetal reduction in the 52 cases of multiple pregnancies was 100%. In the twin pregnancy group after fetal reduction, there was one case of early spontaneous abortion and four cases of late spontaneous abortion. The incidence of fetal birth weight in the multiple-fetus group was significantly lower than that in the single-fetus group [(2.52±0.48) kg vs (3.41±0.31) kg, t=2.495, P 0.05). There was no difference between the single-fetus group and multiple-fetus group in pregnancy hypertension, gestational diabetes mellitus, or postpartum hemorrhage (P>0.05), but the incidence of premature rupture of membranes was significantly higher in the multiple-fetus group than in the single-fetus group (45.2% vs 6.3%, χ2=5.672, P=0.017). Conclusion Vaginal ultrasound-guided selective fetal reduction can significantly improve the pregnancy outcome of multiple pregnancies, representing a safe and effective clinical procedure. Key words: Multiple pregnancy; Fetal reduction; Pregnancy outcome