Fetal Reduction to Twins or A Singleton Pregnancy and Postpartum Complication

Background: Multiple pregnancies are high-risk pregnan-cies and usually were complicated by, pre-eclampsia low birth weight, preterm delivery and augmented perinatal morbidity and mortality. The trans abdominal fetal reduction technique under ultrasound-guided is a practical method for the preven-tion of preterm delivery and medical and obstetric complica-tion associated with multiple pregnancy concluded from ART treatment Materials and Methods: Multiple pregnancy reduction was done in 65 cases of ART pregnancies (IVF) and one quintu-plet, two quadruplet resulting from intrauterine insemination (IUI) and 4 twins using tran abdominal procedure with guiding ultrasonography,others were triplet and reducted to twins or sig-leton pregnancy ,then at every age of termination we considered postpartum hemorrhage and complications until 6 weeks .Results: Of the 65 fetal reduction surgeries, 60 (92.30%) were done between the eleven and fourteen weeks of gestation, five(7.6%) between fourteen and eighteen weeks of gestation .fifty-eight patients (89.23%) underwent reduction from triplets to twins, two from quadruplet to twins, and one from quintuplet to twin pregnancy. One of triplet to twin was failed and aborted but others were successfully performed. After delivery all at ce-sarean section, one case return with bleeding 6 weeks later and had parts of reduced fetus were detected.).Three of 64 (4.68%) cases had sever postpartum hemorrhage and one case had reop-eration due to retained tissue (of reduced missed fetuses).Conclusion: We should pay attention high to risk of postpartum hemrrhage and retained tissue after fetal reduction as a compli-cation even at cesarean section.

کلیدواژه ها:

Fetal Reduction ، Assisted Reproductive Technology ، Post Partum Hemorrhage