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Human Reproduction, Vol. 15, No. 7, 1619-1623, July 2000
© 2000 European Society of Human Reproduction and Embryology

Multifetal reduction of triplets to twins: a prospective comparison of pregnancy outcome

Pierre Boulot1,3, Jacques Vignal1, Christine Vergnes2, Hervé Dechaud1, Jean-Michel Faure1 and Bernard Hedon1

1 Foetal Medicine Unit, Department of Obstetrics and Gynecology, Hopital Arnaud de Villeneuve, Avenue du Doyen Gaston Giraud, 34 000 Montpellier Cedex and 2 Department of Medical Information, Hopital Lapeyronie, Avenue du Doyen Gaston Giraud, 34 000 Montpellier Cedex, France

The aim of this study was to compare the outcome of triplets managed expectantly or by multifetal reduction to twins to assess the potential benefit of fetal reduction. The study design was prospective, comparative and monocentric and the study was conducted in a teaching hospital. Out of 148 women with triplets mostly obtained after infertility treatment, 83 were expectantly managed while 65 chose reduction to obtain twins. Main outcome measures were fetal loss before 24 weeks, premature deliveries before 28, 32 and 34 weeks, rate of low birthweight infants and neonatal and perinatal mortality rates. The fetal loss rate before 24 weeks did not differ between the ongoing group and the reduced group (6 versus 5.4%). Reducing triplets was associated with a signicantly lower incidence of the following: prematurity before 28, 32 and 34 weeks (P < 0.001), low birthweight infants whose weights were under the third centile (P < 0.002) and infants whose weights were less than 1000, 1500 and 2000 g (P < 0.001). Neonatal (although apparently lower in the reduced group) and perinatal mortality did not significantly differ. Our results indicate that reduction of triplets to twins is effective to improve preterm birth and fetal growth.

Key words: multifetal pregnancy reduction/perinatal mortality/prematurity/triplet gestation/twins

3 To whom correspondence should be addressed at: Foetal Medicine Unit, Department of Obstetrics and Gynecology, Hopital Arnaud de Villeneuve, 34 000, Montpellier, France. E-mail: p-boulot{at}chu-montpellier.fr


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