Abstract：
Multiple pregnancies are at increased risk of placental-related complications. The aim of the study was to investigate the prevalence and cumulative incidence of placental-related complications in twin pregnancies undergoing a late selective termination, compared to matched singleton and twin controls.
A retrospective case-control study of post-selective late termination (≥20 weeks of gestation) singletons performed between 2009 and 2020 at a single tertiary center. Each post-termination pregnancy was matched to 2 singleton and 2 dichorionic twin pregnancies for: mode of conception, maternal age group and parity. The prevalence of composite placental related outcome was determined and compared. Kaplan-Meier curves were constructed, and log rank test was performed to compare the cumulative incidence of placental complications among groups.
Included were 90 post-selective termination pregnancies and 360 matched singletons and twins. These were subdivided according to trimester at procedure: 1) late 2nd trimester (N = 43, 20-27.6 weeks); 2) 3rd trimester (N = 47, ≥28 weeks). Placental-related complications presented earlier in the 3rd trimester selective termination group compared to singletons (median 35.5 vs median 37.4 weeks of gestation, P = 0.01). The cumulative incidence of placental-related complications in twins and post-selective termination singletons rose significantly earlier compared to singletons (P < 0.0001). A late 2nd trimester selective termination resulted in a comparable gestational age and cumulative incidence of placental-related complications as singletons.
Compared to singletons, the cumulative incidence of placental complications rises significantly earlier in post-third trimester selective termination singleton pregnancies. While a late 2nd trimester selective termination results in a cumulative incidence comparable to singletons.
A retrospective case-control study of post-selective late termination (≥20 weeks of gestation) singletons performed between 2009 and 2020 at a single tertiary center. Each post-termination pregnancy was matched to 2 singleton and 2 dichorionic twin pregnancies for: mode of conception, maternal age group and parity. The prevalence of composite placental related outcome was determined and compared. Kaplan-Meier curves were constructed, and log rank test was performed to compare the cumulative incidence of placental complications among groups.
Included were 90 post-selective termination pregnancies and 360 matched singletons and twins. These were subdivided according to trimester at procedure: 1) late 2nd trimester (N = 43, 20-27.6 weeks); 2) 3rd trimester (N = 47, ≥28 weeks). Placental-related complications presented earlier in the 3rd trimester selective termination group compared to singletons (median 35.5 vs median 37.4 weeks of gestation, P = 0.01). The cumulative incidence of placental-related complications in twins and post-selective termination singletons rose significantly earlier compared to singletons (P < 0.0001). A late 2nd trimester selective termination resulted in a comparable gestational age and cumulative incidence of placental-related complications as singletons.
Compared to singletons, the cumulative incidence of placental complications rises significantly earlier in post-third trimester selective termination singleton pregnancies. While a late 2nd trimester selective termination results in a cumulative incidence comparable to singletons.
摘要：
多胎妊娠发生胎盘相关并发症的风险增加。该研究的目的是调查在进行晚期选择性终止妊娠的双胎妊娠中胎盘相关并发症的患病率和累积发生率。与匹配的单胎和双胎对照相比。
2009年至2020年在单个三级中心进行的选择性延迟终止妊娠（妊娠≥20周）单胎的回顾性病例对照研究。每次终止妊娠后都与2次单胎和2次双胎妊娠相匹配：受孕模式，产妇年龄组和产次。确定并比较复合胎盘相关结局的患病率。构造了卡普兰-迈耶曲线，采用对数秩检验比较各组胎盘并发症的累积发生率.
包括90个选择性终止妊娠后妊娠和360个匹配的单胎和双胞胎。这些在手术中根据三个月进行细分：1）妊娠晚期（N=43，20-27.6周）；2）妊娠晚期（N=47，≥28周）。与单胎相比，妊娠晚期选择性终止组的胎盘相关并发症较早（中位妊娠35.5周vs中位妊娠37.4周，P=0.01）。与单胎相比，双胎和选择性终止后单胎胎盘相关并发症的累积发生率明显提前上升（P<0.0001）。妊娠晚期选择性终止妊娠的胎龄和胎盘相关并发症的累积发生率与单胎相当。
与单身人士相比,在妊娠晚期后选择性终止单胎妊娠中,胎盘并发症的累积发生率明显提前上升.而妊娠晚期选择性终止导致与单例相当的累积发生率。
2009年至2020年在单个三级中心进行的选择性延迟终止妊娠（妊娠≥20周）单胎的回顾性病例对照研究。每次终止妊娠后都与2次单胎和2次双胎妊娠相匹配：受孕模式，产妇年龄组和产次。确定并比较复合胎盘相关结局的患病率。构造了卡普兰-迈耶曲线，采用对数秩检验比较各组胎盘并发症的累积发生率.
包括90个选择性终止妊娠后妊娠和360个匹配的单胎和双胞胎。这些在手术中根据三个月进行细分：1）妊娠晚期（N=43，20-27.6周）；2）妊娠晚期（N=47，≥28周）。与单胎相比，妊娠晚期选择性终止组的胎盘相关并发症较早（中位妊娠35.5周vs中位妊娠37.4周，P=0.01）。与单胎相比，双胎和选择性终止后单胎胎盘相关并发症的累积发生率明显提前上升（P<0.0001）。妊娠晚期选择性终止妊娠的胎龄和胎盘相关并发症的累积发生率与单胎相当。
与单身人士相比,在妊娠晚期后选择性终止单胎妊娠中,胎盘并发症的累积发生率明显提前上升.而妊娠晚期选择性终止导致与单例相当的累积发生率。
