Maryam Nurzadeh - Department of Feto-Maternal, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Maryam Moshfeghi - Department of Endocrinology and Female infertility, Royan Institute, Reproductive Biomedicine Research Center, ACECR, Tehran, Iran
Mamak Shariat - epartment of Feto-Maternal, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Ashraf Sadat Jamal - Shariatic Hospital, Tehran University of Medical Sciences, Tehran, Iran
Vajiheh Marsoosi - Department of Obstetrics and Gynecology, Tehran University of Medical Sciences, Tehran, Iran
Laleh Eslamian - Department of Obstetrics and Gynecology, Tehran University of Medical Sciences, Tehran, Iran
Mahsa Naemi - Department of Obstetrics and Gynecology, Shariatic hospital,Tehran university of medical sciences, Tehran, iran
Maria Nezam Nia - Department of Obstetrics and Gynecology, School of Medicine, Pasteur Hospital, Bam University of Medical Sciences, Tehran, Iran
Fedyeh Haghollahi - Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
Seyede Houra Mousavi Vahed - Department of Obstetrics and Gynecology, Tehran University of Medical Sciences, Tehran, Iran

Background & Objective: A number of procedures have been developed for multifetal pregnancy reduction (MPR) to reduce the overall number of fetuses in the gestation and improve the maternal outcomes as well as the outcomes of the surviving fetus.Materials & Methods: An observational historical cohort study was conducted on multiple pregnancies that underwent fetal reduction in Shariati Hospital and Omid Clinic between January ۲۰۱۸ and September ۲۰۲۱. The study population was divided into two groups according to gestational age at fetal reduction: ۱۱–۱۴ weeks' gestation (early reduction group) and ۱۵–۱۹ weeks’ gestation (late reduction group). The main outcome measures were the rates of pregnancy complications, pregnancy loss, preterm delivery, and adverse neonatal outcomes.Results: The study group included ۱۰۷ patients with twin and multiple pregnancies that underwent abdominal MPR at ۱۱-۱۹ weeks’ gestation (۷۹ in the early reduction group and ۲۸ in the late group). The incidence of pregnancy complications (hypertension, diabetes, intrauterine growth disorder, preterm delivery, and pregnancy loss) was not significantly different between the two groups (P >۰.۰۵). The percentage of NICU admission was higher in the early reduction group compared to the late group (۴۹% vs ۱۸.۵%, P=۰.۰۰۴). The weight of the first newborn was significantly heavier in the late versus early reduction group (۲۶۸۰.۵۵±۷۷۷.۵۲ vs ۲۲۶۴.۴±۷۹۶.۸۲, P=۰.۰۰۵).Conclusion: According to the present study, fetal reduction in twin or multiple pregnancies is a safe procedure with good obstetric outcomes if done by an expert specialist, especially when it is performed in the second trimester.

fetal abnormalities, Multifetal pregnancy reduction, Multiple Pregnancy, Perinatal outcome, Selective termination, Twin pregnancy