The effectiveness of multifetal pregnancy reduction in trichorionic triplet gestation

Lidewij Van De Mheen*, Sheila M.P. Everwijn, Maarten F.C.M. Knapen, Dick Oepkes, Melanie Engels, Gwendolyn T.R. Manten, Hans Zondervan, Soetinah A.M. Wirjosoekarto, John M.G. Van Vugt, Jan Jaap H.M. Erwich, Sebastiaan W.A. Nij Bijvank, Anita Ravelli, Steffie Heemelaar, Maria G. Van Pampus, Christianne J.M. De Groot, Ben W.J. Mol, Eva Pajkrt

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

40 Citations (Scopus)


Objective The objective of the study was to assess in trichorionic triplet pregnancies the effectiveness of elective reduction to twins. Study Design This was a nationwide retrospective cohort study. We compared the time to delivery and perinatal mortality in trichorionic triplet pregnancies electively reduced to twins with ongoing trichorionic triplets and primary dichorionic twins. Results We identified 86 women with reduced trichorionic triplet pregnancies, 44 with ongoing trichorionic triplets, and 824 with primary twins. Reduced triplets had a median gestational age at delivery of 36.1 weeks (interquartile range [IQR], 33.3-37.5 weeks) vs 33.3 (IQR, 28.1-35.2) weeks for ongoing triplets and 37.1 (IQR, 35.3-38.1) weeks for primary twins (P <.001). The total number of surviving children in the reduced group was 155 (90%) vs 114 (86%) in the ongoing triplet group. After reduction, 75 of women (87%) had all their fetuses surviving, compared with 36 (82%) (relative risk [RR], 1.3; 95% confidence interval [CI], 0.72-2.3) for ongoing triplets and 770 (93%) (RR, 0.91; 95% CI, 0.82-1) for primary twins. There were 6 women without any surviving children (7%) after reduction vs 5 (11.4%) (RR, 0.81; 95% CI, 0.47-1.4) among women with ongoing triplets and 32 (3.9%) (RR, 1.7; 95% CI, 0.8-3.7) in women with primary twins. Conclusion In women with a triplet pregnancy, fetal reduction increases gestational age at birth with 3 weeks as compared with ongoing triplets. However, there the impact on neonatal survival is limited.

Original languageEnglish
Pages (from-to)536.e1-536.e6
JournalAmerican Journal of Obstetrics and Gynecology
Issue number5
Publication statusPublished - 1 Nov 2014


  • multifetal pregnancy reduction
  • multiple pregnancy
  • pregnancy outcome


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