Pregnancy Outcomes and Nursing Care in a Large Cohort of Multiple Pregnancy Cases Undergoing Transvaginal Multifetal Pregnancy Reduction

Mingfen Deng; Yulian Liang; Hua Qin; Li Zhou; Liping Chen; Lu Luo

doi:doi:10.11648/j.ajns.20180706.13

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Pregnancy Outcomes and Nursing Care in a Large Cohort of Multiple Pregnancy Cases Undergoing Transvaginal Multifetal Pregnancy Reduction

Mingfen Deng, Yulian Liang, Hua Qin, Li Zhou, Liping Chen, Lu Luo

Published in American Journal of Nursing Science (Volume 7, Issue 6)

Received: 17 September 2018 Accepted: 6 October 2018 Published: 29 October 2018

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Abstract

Assisted reproductive techniques (ART) frequently result in multiple pregnancy, which in some cases poses a danger to the mother and may reduce fetal health and take-home baby rate. These adverse outcomes may be mitigated by transvaginal pregnancy reduction, but the perioperative nursing care related to good outcome has not been reported in large cohorts. This study therefore analyzed the pregnancy outcomes of twin and triplet pregnancies following early transvaginal multifetal pregnancy reduction, and summarized the experiences of perioperative nursing care. A total of 204 twin or triplet pregnancies conceived by ART who underwent transvaginal multifetal pregnancy reduction during gestational week 7 to 8 were retrospectively analyzed. Main outcome measures included operation success rate as well as rates of spontaneous abortion, preterm delivery, and cesarean section. Birth weight, gestational age at delivery, and take-home baby rate were also analyzed. The success rate of multifetal reduction was 100% with no perioperative complications. Pregnancy outcome after multifetal pregnancy reduction was satisfactory, with a take-home baby rate of 76.9% for twin-to singleton, 89.5% for triplet-to-twin reduction, and 92.3% for triplet-to singleton reduction. Perioperative nursing procedures critical for good outcome included facilitation of routine preoperative tests for surgical contraindications, pre- and intra-operative stress and anxiety counseling, disinfection and flushing of the vagina and perineum, inspection of aspiration equipment, postoperative management of diet, and education on postoperative signs of abnormality. In conclusion, multifetal reduction achieved satisfactory pregnancy outcomes. Efficient nursing care during the perioperative period is one of the most important factors for improved outcome following multifetal pregnancy reduction.

Published in	American Journal of Nursing Science (Volume 7, Issue 6)
DOI	10.11648/j.ajns.20180706.13
Page(s)	218-222
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

Multifetal Fetal Reduction, Assisted Reproductive Technique, Multiple Pregnancy, Pregnancy Outcome, Nursing Care

References

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[2]	Society for Assisted Reproductive Technology (SART). National Summary Report. https://www.sartcorsonline.com/rptCSR_PublicMultYear.aspx?ClinicPKID¼0. Accessed January 12, 2017.
[3]	American College of Obstetricians and Gynecologists. Multifetal gestations: twin, triplet, and higher-order multifetal pregnancies. ACOG Practice bulletin no. 144. Obstet Gynecol 2013; 123: 1118-32.
[4]	Sunderam S, Kissin DM, Crawford SB, Folger SG, Jamieson DJ, Warner L, Barfield WD. Assisted reproductive technology surveillance-United States, 2013. MMWR Surveill Summ 2015; 64, 1-25.
[5]	Coffler MS, Kol S, Drugan A, Itskovitz-Eldor J. Early transvaginal embryo aspiration: a safer method for selective reduction in high order multiple gestations. Hum Reprod 1999; 14: 1875-8.
[6]	Lin H, Wen Y, Li Y, Chen X, Yang D, Zhang Q. Early fetal reduction of dichorionic triplets to dichorionic twin or singleton pregnancies: a retrospective study. Reprod Biomed Online 2016; 32: 490-5.
[7]	Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet 2008; 371: 75-84.
[8]	Mamopoulos A, Petousis S, Tsimpanakos J et al. Birth weight independently affects morbidity and mortality of extremely preterm neonates [J]. J Clin Med Res. 2015, 7(7):5.
[9]	Cheong MA, Tay SK. {F5et} Application of legal principles and medical ethics: multifetal pregnancy and fetal reduction [J]. {/F5et} Singapore Med J. 2014, 55 (6):298-301.
[10]	Haas J, Mohr Sasson A, Barzilay E et al. Perinatal outcome after fetal reduction from twin to singleton: to reduce or not to reduce? [J] Fertil Steril, 2015, 103(2):428-32.
[11]	Hasson J, Shapira A, Many A, Jaffa A et al. Reduction of twin pregnancy to singleton: does it improve pregnancy outcome J Matern Fetal Neonatal Med 2011, 24(11):1362-6.
[12]	Antsaklis A, Anastasakis E. Selective reduction in twins and multiple pregnancies. J Perinat Med 2011; 39: 15-21.
[13]	Luo Qiuju, Zhu Jianhong. Experiences in nursing care for 11 cases of multiple pregnancy embryo aspiration and fetal reduction [J]. Journal of Qiqihar Medical College, 2014, 35 (10): 1543-1544.
[14]	Chen Y, Zhang H. Nursing care for 26 cases undergoing multifetal pregnancy reduction. Nursing Research, 2014, 10 (28): 1680-1681.
[15]	Sullivan EA, Wang YA, Hayward I, Chambers GM, Illingworth P, McBain J, et al. Single embryo transfer reduces the risk of perinatal mortality, a population study. Hum Reprod 2012; 27: 3609-15.

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APA Style

Mingfen Deng, Yulian Liang, Hua Qin, Li Zhou, Liping Chen, et al. (2018). Pregnancy Outcomes and Nursing Care in a Large Cohort of Multiple Pregnancy Cases Undergoing Transvaginal Multifetal Pregnancy Reduction. American Journal of Nursing Science, 7(6), 218-222. https://doi.org/10.11648/j.ajns.20180706.13

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ACS Style

Mingfen Deng; Yulian Liang; Hua Qin; Li Zhou; Liping Chen, et al. Pregnancy Outcomes and Nursing Care in a Large Cohort of Multiple Pregnancy Cases Undergoing Transvaginal Multifetal Pregnancy Reduction. Am. J. Nurs. Sci. 2018, 7(6), 218-222. doi: 10.11648/j.ajns.20180706.13

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AMA Style

Mingfen Deng, Yulian Liang, Hua Qin, Li Zhou, Liping Chen, et al. Pregnancy Outcomes and Nursing Care in a Large Cohort of Multiple Pregnancy Cases Undergoing Transvaginal Multifetal Pregnancy Reduction. Am J Nurs Sci. 2018;7(6):218-222. doi: 10.11648/j.ajns.20180706.13

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@article{10.11648/j.ajns.20180706.13,
  author = {Mingfen Deng and Yulian Liang and Hua Qin and Li Zhou and Liping Chen and Lu Luo},
  title = {Pregnancy Outcomes and Nursing Care in a Large Cohort of Multiple Pregnancy Cases Undergoing Transvaginal Multifetal Pregnancy Reduction},
  journal = {American Journal of Nursing Science},
  volume = {7},
  number = {6},
  pages = {218-222},
  doi = {10.11648/j.ajns.20180706.13},
  url = {https://doi.org/10.11648/j.ajns.20180706.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajns.20180706.13},
  abstract = {Assisted reproductive techniques (ART) frequently result in multiple pregnancy, which in some cases poses a danger to the mother and may reduce fetal health and take-home baby rate. These adverse outcomes may be mitigated by transvaginal pregnancy reduction, but the perioperative nursing care related to good outcome has not been reported in large cohorts. This study therefore analyzed the pregnancy outcomes of twin and triplet pregnancies following early transvaginal multifetal pregnancy reduction, and summarized the experiences of perioperative nursing care. A total of 204 twin or triplet pregnancies conceived by ART who underwent transvaginal multifetal pregnancy reduction during gestational week 7 to 8 were retrospectively analyzed. Main outcome measures included operation success rate as well as rates of spontaneous abortion, preterm delivery, and cesarean section. Birth weight, gestational age at delivery, and take-home baby rate were also analyzed. The success rate of multifetal reduction was 100% with no perioperative complications. Pregnancy outcome after multifetal pregnancy reduction was satisfactory, with a take-home baby rate of 76.9% for twin-to singleton, 89.5% for triplet-to-twin reduction, and 92.3% for triplet-to singleton reduction. Perioperative nursing procedures critical for good outcome included facilitation of routine preoperative tests for surgical contraindications, pre- and intra-operative stress and anxiety counseling, disinfection and flushing of the vagina and perineum, inspection of aspiration equipment, postoperative management of diet, and education on postoperative signs of abnormality. In conclusion, multifetal reduction achieved satisfactory pregnancy outcomes. Efficient nursing care during the perioperative period is one of the most important factors for improved outcome following multifetal pregnancy reduction.},
 year = {2018}
}

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TY  - JOUR
T1  - Pregnancy Outcomes and Nursing Care in a Large Cohort of Multiple Pregnancy Cases Undergoing Transvaginal Multifetal Pregnancy Reduction
AU  - Mingfen Deng
AU  - Yulian Liang
AU  - Hua Qin
AU  - Li Zhou
AU  - Liping Chen
AU  - Lu Luo
Y1  - 2018/10/29
PY  - 2018
N1  - https://doi.org/10.11648/j.ajns.20180706.13
DO  - 10.11648/j.ajns.20180706.13
T2  - American Journal of Nursing Science
JF  - American Journal of Nursing Science
JO  - American Journal of Nursing Science
SP  - 218
EP  - 222
PB  - Science Publishing Group
SN  - 2328-5753
UR  - https://doi.org/10.11648/j.ajns.20180706.13
AB  - Assisted reproductive techniques (ART) frequently result in multiple pregnancy, which in some cases poses a danger to the mother and may reduce fetal health and take-home baby rate. These adverse outcomes may be mitigated by transvaginal pregnancy reduction, but the perioperative nursing care related to good outcome has not been reported in large cohorts. This study therefore analyzed the pregnancy outcomes of twin and triplet pregnancies following early transvaginal multifetal pregnancy reduction, and summarized the experiences of perioperative nursing care. A total of 204 twin or triplet pregnancies conceived by ART who underwent transvaginal multifetal pregnancy reduction during gestational week 7 to 8 were retrospectively analyzed. Main outcome measures included operation success rate as well as rates of spontaneous abortion, preterm delivery, and cesarean section. Birth weight, gestational age at delivery, and take-home baby rate were also analyzed. The success rate of multifetal reduction was 100% with no perioperative complications. Pregnancy outcome after multifetal pregnancy reduction was satisfactory, with a take-home baby rate of 76.9% for twin-to singleton, 89.5% for triplet-to-twin reduction, and 92.3% for triplet-to singleton reduction. Perioperative nursing procedures critical for good outcome included facilitation of routine preoperative tests for surgical contraindications, pre- and intra-operative stress and anxiety counseling, disinfection and flushing of the vagina and perineum, inspection of aspiration equipment, postoperative management of diet, and education on postoperative signs of abnormality. In conclusion, multifetal reduction achieved satisfactory pregnancy outcomes. Efficient nursing care during the perioperative period is one of the most important factors for improved outcome following multifetal pregnancy reduction.
VL  - 7
IS  - 6
ER  -

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Author Information

Mingfen Deng

Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Yulian Liang

Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Hua Qin

Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Li Zhou

Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Liping Chen

Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Lu Luo

Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China

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APA Style

Mingfen Deng, Yulian Liang, Hua Qin, Li Zhou, Liping Chen, et al. (2018). Pregnancy Outcomes and Nursing Care in a Large Cohort of Multiple Pregnancy Cases Undergoing Transvaginal Multifetal Pregnancy Reduction. American Journal of Nursing Science, 7(6), 218-222. https://doi.org/10.11648/j.ajns.20180706.13

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ACS Style

Mingfen Deng; Yulian Liang; Hua Qin; Li Zhou; Liping Chen, et al. Pregnancy Outcomes and Nursing Care in a Large Cohort of Multiple Pregnancy Cases Undergoing Transvaginal Multifetal Pregnancy Reduction. Am. J. Nurs. Sci. 2018, 7(6), 218-222. doi: 10.11648/j.ajns.20180706.13

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AMA Style

Mingfen Deng, Yulian Liang, Hua Qin, Li Zhou, Liping Chen, et al. Pregnancy Outcomes and Nursing Care in a Large Cohort of Multiple Pregnancy Cases Undergoing Transvaginal Multifetal Pregnancy Reduction. Am J Nurs Sci. 2018;7(6):218-222. doi: 10.11648/j.ajns.20180706.13

Copy | Download

@article{10.11648/j.ajns.20180706.13,
  author = {Mingfen Deng and Yulian Liang and Hua Qin and Li Zhou and Liping Chen and Lu Luo},
  title = {Pregnancy Outcomes and Nursing Care in a Large Cohort of Multiple Pregnancy Cases Undergoing Transvaginal Multifetal Pregnancy Reduction},
  journal = {American Journal of Nursing Science},
  volume = {7},
  number = {6},
  pages = {218-222},
  doi = {10.11648/j.ajns.20180706.13},
  url = {https://doi.org/10.11648/j.ajns.20180706.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajns.20180706.13},
  abstract = {Assisted reproductive techniques (ART) frequently result in multiple pregnancy, which in some cases poses a danger to the mother and may reduce fetal health and take-home baby rate. These adverse outcomes may be mitigated by transvaginal pregnancy reduction, but the perioperative nursing care related to good outcome has not been reported in large cohorts. This study therefore analyzed the pregnancy outcomes of twin and triplet pregnancies following early transvaginal multifetal pregnancy reduction, and summarized the experiences of perioperative nursing care. A total of 204 twin or triplet pregnancies conceived by ART who underwent transvaginal multifetal pregnancy reduction during gestational week 7 to 8 were retrospectively analyzed. Main outcome measures included operation success rate as well as rates of spontaneous abortion, preterm delivery, and cesarean section. Birth weight, gestational age at delivery, and take-home baby rate were also analyzed. The success rate of multifetal reduction was 100% with no perioperative complications. Pregnancy outcome after multifetal pregnancy reduction was satisfactory, with a take-home baby rate of 76.9% for twin-to singleton, 89.5% for triplet-to-twin reduction, and 92.3% for triplet-to singleton reduction. Perioperative nursing procedures critical for good outcome included facilitation of routine preoperative tests for surgical contraindications, pre- and intra-operative stress and anxiety counseling, disinfection and flushing of the vagina and perineum, inspection of aspiration equipment, postoperative management of diet, and education on postoperative signs of abnormality. In conclusion, multifetal reduction achieved satisfactory pregnancy outcomes. Efficient nursing care during the perioperative period is one of the most important factors for improved outcome following multifetal pregnancy reduction.},
 year = {2018}
}

Copy | Download

TY  - JOUR
T1  - Pregnancy Outcomes and Nursing Care in a Large Cohort of Multiple Pregnancy Cases Undergoing Transvaginal Multifetal Pregnancy Reduction
AU  - Mingfen Deng
AU  - Yulian Liang
AU  - Hua Qin
AU  - Li Zhou
AU  - Liping Chen
AU  - Lu Luo
Y1  - 2018/10/29
PY  - 2018
N1  - https://doi.org/10.11648/j.ajns.20180706.13
DO  - 10.11648/j.ajns.20180706.13
T2  - American Journal of Nursing Science
JF  - American Journal of Nursing Science
JO  - American Journal of Nursing Science
SP  - 218
EP  - 222
PB  - Science Publishing Group
SN  - 2328-5753
UR  - https://doi.org/10.11648/j.ajns.20180706.13
AB  - Assisted reproductive techniques (ART) frequently result in multiple pregnancy, which in some cases poses a danger to the mother and may reduce fetal health and take-home baby rate. These adverse outcomes may be mitigated by transvaginal pregnancy reduction, but the perioperative nursing care related to good outcome has not been reported in large cohorts. This study therefore analyzed the pregnancy outcomes of twin and triplet pregnancies following early transvaginal multifetal pregnancy reduction, and summarized the experiences of perioperative nursing care. A total of 204 twin or triplet pregnancies conceived by ART who underwent transvaginal multifetal pregnancy reduction during gestational week 7 to 8 were retrospectively analyzed. Main outcome measures included operation success rate as well as rates of spontaneous abortion, preterm delivery, and cesarean section. Birth weight, gestational age at delivery, and take-home baby rate were also analyzed. The success rate of multifetal reduction was 100% with no perioperative complications. Pregnancy outcome after multifetal pregnancy reduction was satisfactory, with a take-home baby rate of 76.9% for twin-to singleton, 89.5% for triplet-to-twin reduction, and 92.3% for triplet-to singleton reduction. Perioperative nursing procedures critical for good outcome included facilitation of routine preoperative tests for surgical contraindications, pre- and intra-operative stress and anxiety counseling, disinfection and flushing of the vagina and perineum, inspection of aspiration equipment, postoperative management of diet, and education on postoperative signs of abnormality. In conclusion, multifetal reduction achieved satisfactory pregnancy outcomes. Efficient nursing care during the perioperative period is one of the most important factors for improved outcome following multifetal pregnancy reduction.
VL  - 7
IS  - 6
ER  -

Copy | Download