International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2021
Fetal reduction from twin to singleton gestation: A meta-analysis.
СтатьяМетаанализОбзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Bardin Ron, Gupta Mamta, Greenberg Gal, Nandrajog Anchal, Tenenbaum-Gavish Kinneret, Gupta Nikhil, Perlman Sharon, Shmueli Anat, Hadar Eran
Аннотация
OBJECTIVE: To evaluate outcomes of fetal reduction in twin pregnancy.
SEARCH STRATEGY: PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Google Scholar were searched from 1980 through December 2020.
SELECTION CRITERIA: Prospective or retrospective studies of pregnant women with twin gestations who had a transabdominal reduction of twin to singleton pregnancy with a comparison group of ongoing twin gestations.
DATA COLLECTION AND ANALYSIS: Outcomes were meta-analyzed only if reported in at least three studies.
MAIN RESULTS: Six studies with a pooled sample of 2867 women with a twin pregnancy of whom 624 underwent 2-to-1 reduction and 2243 did not. In the fetal reduction group, the odds of preterm birth before 34 and 37 weeks of pregnancy were lower by 36% (odds ratio [OR] 0.64, 95% confidence interval [CI] 0.48-0.86, P < 0.003) and 77% (OR 0.23, 95% CI 0.12-0.44, P < 0.001), respectively, than in the control group, and the odds of hypertensive disorders and cesarean delivery were lower by 75% (OR 0.25, 95% CI 0.15-0.43, P < 0.001) and 65% (OR 0.35, 95% CI 0.20-0.62, P < 0.001), respectively.
CONCLUSION: Twin reduction to singleton pregnancy decreased the possibility of preterm birth, hypertensive disorders in pregnancy and cesarean delivery. Sufficiently powered prospective studies are needed to support these findings.
SEARCH STRATEGY: PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Google Scholar were searched from 1980 through December 2020.
SELECTION CRITERIA: Prospective or retrospective studies of pregnant women with twin gestations who had a transabdominal reduction of twin to singleton pregnancy with a comparison group of ongoing twin gestations.
DATA COLLECTION AND ANALYSIS: Outcomes were meta-analyzed only if reported in at least three studies.
MAIN RESULTS: Six studies with a pooled sample of 2867 women with a twin pregnancy of whom 624 underwent 2-to-1 reduction and 2243 did not. In the fetal reduction group, the odds of preterm birth before 34 and 37 weeks of pregnancy were lower by 36% (odds ratio [OR] 0.64, 95% confidence interval [CI] 0.48-0.86, P < 0.003) and 77% (OR 0.23, 95% CI 0.12-0.44, P < 0.001), respectively, than in the control group, and the odds of hypertensive disorders and cesarean delivery were lower by 75% (OR 0.25, 95% CI 0.15-0.43, P < 0.001) and 65% (OR 0.35, 95% CI 0.20-0.62, P < 0.001), respectively.
CONCLUSION: Twin reduction to singleton pregnancy decreased the possibility of preterm birth, hypertensive disorders in pregnancy and cesarean delivery. Sufficiently powered prospective studies are needed to support these findings.