Abstract:

Objective To analyze the effectiveness and feasibility of selective multifetal pregnancy reduc⁃ tion（MFPR）in triplet pregnancy with different chorionic properties. Methods A total of 33 patients obtaining triplet pregnancy with different chorionic properties by assisted reproductive technology and undergoing selective MFPR in the Department of Reproductive Medicine，Guangdong Provincial Fertility Hospital were retrospectively analyzed，including 14 dichorionic⁃triamniotic（DCTA）triplet pregnancies and 19 trichorionic⁃triamniotic（TCTA） triplet pregnancies. Sixty dichorionic⁃diamniotic（DCDA）twin pregnancies without MFPR were collected as con⁃ trols. The pregnancy outcomes，pregnancy complications，and neonatal status were compared among the three groups. Results All thepatients undergoing selective MFPR were successful to have DCDA twin pregnancy after the procedure. Spontaneous pregnancy reduction occurred in 10 DCTA triplet pregnancies（10/14，71.4%）but not in TCTA anytriplet pregnancy（0/19，0.0%）one day aftertheprocedure. The difference between the two groups was statistically significant（P < 0.05）. There were no significant differences in the rates of spontaneous pregnancy reduction and spontaneous abortion among three groups（P > 0.05）. The singleton live birth rate and gestational weekat delivery were significantly higher in the DCTA triplet pregnancy group［75%，（38.3 ± 2.2）weeks］than in the TCTA triplet pregnancy and DCDA twin pregnancy groups［5.3%，（36.6 ± 1.7）weeks；17.5%，（37.1 ± 1.7）weeks）］（P < 0.05）. Conclusions Selective MFPR for patients with DCTA or TCTA triplet pregnancy is safeand feasible. Reduction of one MCDA fetal in patients with DCTA triplet pregnancy might significantly increase spontaneous pregnancy reduction rateinthe other MCDA fetal. The patients with triplet pregnancy should be fully informed the relevantrisk of MFPR，especially those with DCTA triplet pregnancy undergoing reduction of one MCDA fetal.

Key words:

multifetal pregnancy reduction, triplet pregnancy, pregnancy outcome, safety