דילול תאומים מאחד לשניים
דיון מתוך פורום פריון האישה והפריה חוץ גופית
אני בשבוע שמיני ושוקלת דילול של אחד משני העוברים. האם יש סיכונים בדילול (למעט איבוד כל ההריון)? האם יש סיכוי של נזק לעובר שנשאר, או סיכוי ללידה מוקדמת (וכתוצאה מכך פגמים ונזקים, פגות ארוכה וכד')? בתודה.
כמו בכל פעולה פולשנית ברחם יש סיכון נדיר להחדרת זיהום שיסכן את הרחם ואף אותך. הפחתה מפחיתה את הסיכון ללידה מוקדמת בהשוואה לתאומים. ראי מאמר חדש משיבא: Fertil Steril. 2014 Nov 20. pii: S0015-0282(14)02287-0. doi: 10.1016/j.fertnstert.2014.10.027. [Epub ahead of print] Perinatal outcome after fetal reduction from twin to singleton: To reduce or not to reduce? Haas J1, Mohr Sasson A2, Barzilay E2, Mazaki Tovi S2, Orvieto R2, Weisz B2, Lipitz S2, Yinon Y2. Author information Abstract OBJECTIVE: To determine whether reduction of twin gestation to singleton pregnancy is associated with improved perinatal outcome. DESIGN: A retrospective cohort study. SETTING: Single tertiary care medical center. PATIENT(S): A cohort of 63 singleton pregnancies after reduction from dichorionic-diamniotic twins gestation and 62 dichorionic-diamniotic nonreduced twins. INTERVENTION(S): Fetal reduction between 11 and 14 weeks of gestation. MAIN OUTCOME MEASURE(S): Obstetric outcome. RESULT(S): The rates of preterm delivery at <34 weeks (1.6% in pregnancies after reduction vs. 11.7% in nonreduced twins) and at <37 weeks of gestation (9.5% vs. 56.7%) were significantly lower in patients whose pregnancies were reduced to singletons. The rates of miscarriage of one twin (0% vs. 4.8%) and early pregnancy loss before 24 weeks of gestation as well as the rates of gestational diabetes (11.1% vs. 10%), hypertensive diseases of pregnancy (6.3% vs. 15%), and intrauterine growth restriction (0% vs. 3.3%) were similar in both groups. CONCLUSION(S): Fetal reduction of twins to singleton is associated with a lower risk of prematurity and superior perinatal outcome compared with nonreduced twins. Therefore, the option of fetal reduction should be considered in certain cases of twin pregnancies, where the risk for adverse outcome seems exceptionally high.