OP06.01: Diagnosis of placental insufficiency with magnetic resonance imaging using the Diffusion Weighted Imaging (DWI) on a murine model of vascular fetal growth restriction

Abstract

Objectives: The purpose of this study was to evaluate pregnancy outcome in multiple pregnancies showed early complications after selective multifetal pregnancy reduction (MFPR). Methods: This was a retrospective study evaluating the outcome of 187 multiple pregnancies after embryo reduction at 10th –14th week of gestation in our center. A needle was inserted into the uterus transabdominally and potassium chloride was injected into the fetal thorax. Using data derived from this study and from a review of studies reporting on survival and early complications by gestational age in singletons, the effects of embryo reduction on pregnancy outcome rates were estimated. Main outcome measures were rupture of membranes, uterine contractions, vaginal discharge, chorioamnionitis, miscarriage before 24 weeks of gestation and preterm delivery before 32 weeks. Results: In 185/187 (98.9%) we retrieved outcome results. In 31/185 (16.7%) MFPR early complications were reported within a week, as rupture of membranes, uterine contractions, vaginal discharge and chorioamnionitis were 17/185 (9.2%), 4/185 (2.2%), 7/185 (3.7%) and 3/185 (1.6%) respectively. 4/31 (12.9%) were miscarried until 24th week of gestation and 27/31 (87.1%) delivered healthy neonates. The overall rate of miscarriage was 12/185 (6.4%) from whom 4/12 (33.3%) had early complications and 8/12 (66.7%) didn’t have any. Preterm labour before 32 weeks was 14/185 (7.5%) from whom only 1 had early complications. Regarding miscarriage and preterm labour, no statistical differences were observed between group of women with early complications and women with no complications. Early complications (25% vs. 3.7%) and pregnancy loss before 24 weeks (7.6% vs. 3.7%) were higher when the reduction was to twins rather in reduction to a single fetus. Conclusions: The incidence of early complications after selective embryo reduction in multiple pregnancies is relatively high. However, there is no correlation between early complications within a week and miscarriage or preterm labour before 32 weeks of gestation. OP06: PREDICTION AND DIAGNOSIS OF PLACENTAL DISEASE