Abstract：
UNASSIGNED: Foetal reduction, which involves selectively terminating one or more foetuses in a multiple gestation pregnancy, has become more common. This systematic review and meta-analysis aims to assess and compare pregnancy outcomes of foetal reduction from twin to singleton gestation to ongoing twin gestations.
UNASSIGNED: A comprehensive search of electronic databases (MEDLINE, EMbase, Cochrane Library, CINAHL and PsycINFO) was done for studies published until 15 April 2023. The outcomes analysed included gestational diabetes mellitus (DM), hypertension, caesarean delivery, foetal loss, perinatal death, preterm birth (PTB), intrauterine growth restriction (IUGR), preterm prelabour rupture of membranes (PPROM) and birth weight.
UNASSIGNED: A total of 13 studies comprising 1241 cases of twin to singleton foetal reduction gestation were compared to 20,693 ongoing twin gestations. Our findings indicate that foetal reduction was associated with a significantly lower risk of developing maternal gestational DM (odds ratio [OR] = 0.40, 95% confidence interval [CI] 0.27-0.59) and hypertension (OR = 0.36, 95% CI 0.23-0.57) compared to the control group. Incidence rate of caesarean delivery (OR = 0.65, 95% CI 0.53-0.81) after foetal reduction was significantly lower compared to ongoing twin gestations. There was a 63% lower chance of PTB before 37 weeks of pregnancy. However, there was no significant association between foetal reduction and outcomes such as foetal loss, perinatal death, IUGR and PPROM.
UNASSIGNED: Our findings suggest that foetal twin to singleton reduction entails potential benefits as compared to ongoing twin gestations. Further well planned studies are needed to explore underlying mechanisms to understanding of the outcomes associated with foetal reduction procedures and inform clinical decision-making for pregnant individuals and healthcare providers alike.
Foetal reduction, a procedure where one or more foetuses in a twin pregnancy are selectively terminated, has become more common. This study reviewed existing research to compare the outcomes of foetal reduction to singleton pregnancies with those of ongoing twin pregnancies. The study found that mothers who underwent foetal reduction had a lower risk of developing gestational diabetes and hypertension, and they were less likely to have a caesarean delivery. There was also a reduced chance of preterm birth before 37 weeks. However, foetal reduction did not appear to significantly impact outcomes like foetal loss, perinatal death, intrauterine growth restriction or preterm pre-labour rupture of membranes. It is important to note that there is some variation in the results among different studies, and more research is needed to fully understand these findings.
UNASSIGNED: A comprehensive search of electronic databases (MEDLINE, EMbase, Cochrane Library, CINAHL and PsycINFO) was done for studies published until 15 April 2023. The outcomes analysed included gestational diabetes mellitus (DM), hypertension, caesarean delivery, foetal loss, perinatal death, preterm birth (PTB), intrauterine growth restriction (IUGR), preterm prelabour rupture of membranes (PPROM) and birth weight.
UNASSIGNED: A total of 13 studies comprising 1241 cases of twin to singleton foetal reduction gestation were compared to 20,693 ongoing twin gestations. Our findings indicate that foetal reduction was associated with a significantly lower risk of developing maternal gestational DM (odds ratio [OR] = 0.40, 95% confidence interval [CI] 0.27-0.59) and hypertension (OR = 0.36, 95% CI 0.23-0.57) compared to the control group. Incidence rate of caesarean delivery (OR = 0.65, 95% CI 0.53-0.81) after foetal reduction was significantly lower compared to ongoing twin gestations. There was a 63% lower chance of PTB before 37 weeks of pregnancy. However, there was no significant association between foetal reduction and outcomes such as foetal loss, perinatal death, IUGR and PPROM.
UNASSIGNED: Our findings suggest that foetal twin to singleton reduction entails potential benefits as compared to ongoing twin gestations. Further well planned studies are needed to explore underlying mechanisms to understanding of the outcomes associated with foetal reduction procedures and inform clinical decision-making for pregnant individuals and healthcare providers alike.
Foetal reduction, a procedure where one or more foetuses in a twin pregnancy are selectively terminated, has become more common. This study reviewed existing research to compare the outcomes of foetal reduction to singleton pregnancies with those of ongoing twin pregnancies. The study found that mothers who underwent foetal reduction had a lower risk of developing gestational diabetes and hypertension, and they were less likely to have a caesarean delivery. There was also a reduced chance of preterm birth before 37 weeks. However, foetal reduction did not appear to significantly impact outcomes like foetal loss, perinatal death, intrauterine growth restriction or preterm pre-labour rupture of membranes. It is important to note that there is some variation in the results among different studies, and more research is needed to fully understand these findings.
摘要：
■胎儿减少，这涉及在多胎妊娠中选择性终止一个或多个胎儿，变得更加普遍。这项系统评价和荟萃分析旨在评估和比较从双胎到单胎妊娠到持续双胎妊娠的胎儿减少的妊娠结局。
■电子数据库的全面搜索(MEDLINE，EMBase,科克伦图书馆,CINAHL和PsycINFO）的研究发表至2023年4月15日。分析的结果包括妊娠期糖尿病（DM），高血压,剖腹产,胎儿丢失,围产期死亡,早产（PTB），宫内生长受限（IUGR），早产胎膜破裂（PPROM）和出生体重。
■总共13项研究，包括1241例双胞胎至单胎胎儿减少妊娠与20,693例正在进行的双胞胎妊娠进行了比较。我们的研究结果表明，与对照组相比，胎儿减少与孕妇发生妊娠期糖尿病（比值比[OR]=0.40，95％置信区间[CI]0.27-0.59）和高血压（OR=0.36，95％CI0.23-0.57）的风险显着降低相关。与持续双胎妊娠相比，胎儿减少后剖宫产的发生率（OR=0.65，95％CI0.53-0.81）显着降低。妊娠37周前发生PTB的几率降低63%。然而,胎儿减少与胎儿丢失等结局之间没有显着关联，围产期死亡,IUGR和PPROM。
■我们的研究结果表明，与持续的双胎妊娠相比，胎儿双胎到单胎减少具有潜在的益处。需要进一步的精心计划的研究，以探索了解与胎儿减少程序相关的结果的潜在机制，并为孕妇和医疗保健提供者的临床决策提供信息。
胎儿减少，选择性终止双胎妊娠中的一个或多个胎儿的程序，变得更加普遍。这项研究回顾了现有的研究，以比较胎儿减少与单胎妊娠的结局与持续双胎妊娠的结局。研究发现，接受胎儿复位术的母亲患妊娠期糖尿病和高血压的风险较低，他们不太可能剖腹产。在37周之前早产的机会也减少了。然而,胎儿减少似乎没有显着影响结果，如胎儿丢失，围产期死亡,宫内生长受限或早产胎膜破裂。重要的是要注意，不同研究之间的结果存在一些差异，需要更多的研究来充分理解这些发现。
■电子数据库的全面搜索(MEDLINE，EMBase,科克伦图书馆,CINAHL和PsycINFO）的研究发表至2023年4月15日。分析的结果包括妊娠期糖尿病（DM），高血压,剖腹产,胎儿丢失,围产期死亡,早产（PTB），宫内生长受限（IUGR），早产胎膜破裂（PPROM）和出生体重。
■总共13项研究，包括1241例双胞胎至单胎胎儿减少妊娠与20,693例正在进行的双胞胎妊娠进行了比较。我们的研究结果表明，与对照组相比，胎儿减少与孕妇发生妊娠期糖尿病（比值比[OR]=0.40，95％置信区间[CI]0.27-0.59）和高血压（OR=0.36，95％CI0.23-0.57）的风险显着降低相关。与持续双胎妊娠相比，胎儿减少后剖宫产的发生率（OR=0.65，95％CI0.53-0.81）显着降低。妊娠37周前发生PTB的几率降低63%。然而,胎儿减少与胎儿丢失等结局之间没有显着关联，围产期死亡,IUGR和PPROM。
■我们的研究结果表明，与持续的双胎妊娠相比，胎儿双胎到单胎减少具有潜在的益处。需要进一步的精心计划的研究，以探索了解与胎儿减少程序相关的结果的潜在机制，并为孕妇和医疗保健提供者的临床决策提供信息。
胎儿减少，选择性终止双胎妊娠中的一个或多个胎儿的程序，变得更加普遍。这项研究回顾了现有的研究，以比较胎儿减少与单胎妊娠的结局与持续双胎妊娠的结局。研究发现，接受胎儿复位术的母亲患妊娠期糖尿病和高血压的风险较低，他们不太可能剖腹产。在37周之前早产的机会也减少了。然而,胎儿减少似乎没有显着影响结果，如胎儿丢失，围产期死亡,宫内生长受限或早产胎膜破裂。重要的是要注意，不同研究之间的结果存在一些差异，需要更多的研究来充分理解这些发现。
