Obstetric and neonatal outcome of multifetal pregnancy reduction

Abstract Objective To evaluate obstetric and neonatal outcomes of multifetal pregnancy reduction (MFPR) in patients with higher order multiple pregnancies (HOMP) compared to those managed expectantly. Methods Forty patients with HOMP (quadruplets or more) were included. Seventeen patients were reduced and 23 patients were non-reduced as per patient's choice. Obstetric and neonatal outcome measures were compared. Results The mean gestational age at the procedure was 12.8 ± 0.9 weeks. Five cases out of fifteen were reduced to triplets and 10 cases were reduced to twins. The mean total volume of KCL used was 5.4 ± 1.3 ml and the mean number of attempts was 1 ± 0.4. The most frequent complications were maternal anxiety and abdominal pain (29.4%). The procedure failed in two cases due to abdominal pain and maternal distress. The differences regarding preterm labor, gestational age at delivery, mode of delivery and neonatal birth weight were statistically significant. This was in favor of MFPR procedure. Conclusion MFPR procedure seems to be good and acceptable option for patients with HOMP but not totally safe.