Gestaciones múltiples de alto orden

Translated title of the contribution: High order multiple gestations

M. I. Evans, D. Ciorica, D. W. Britt, J. C. Fletcher

Research output: Contribution to journalArticlepeer-review

Abstract

Over the past 20 years, multifetal pregnancy reduction (MFPR) has emerged as an invaluable tool in dealing with the sequelae from overly "successful" infertility treatments. A small number of centers around the world have developed the technique which has allowed thousands of couples who would have otherwise either lost their pregnancy entirely or had high risk of extremely early delivery to achieve gestations of i more advanced age and with lowered perinatal morbidity and mortality. Recent data suggest that the outcomes of gestations beginning with triplets, quadruplets, and perhaps quintuplets that are reduced to twins behave essentially as if they started as twins. Over the past decade there has been a continuing shift in the demographics of patients we see. They have become older, more likely to be using donor eggs, and more likely to have had their gestation achieved by IVF. An increasing proportion of patients now wishes reduction to a singleton, and recent data suggest that even starting with twins that reduction to a singleton improves outcomes. Concomitantly, the use of chorionic villus sampling (CVS) prior to MFPR allows for the ability to increase the likelihood of normal children. We now perform CVS prior to reduction in the majority of patients which in experienced hands appears to be a very safe and efficacious method for improving perinatal outcome.

Translated title of the contributionHigh order multiple gestations
Original languageSpanish
Pages (from-to)31-42
Number of pages12
JournalCuadernos de Medicina Reproductiva
Volume10
Issue number1
StatePublished - 2004
Externally publishedYes

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