{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T10:39:45Z","timestamp":1788950385344,"version":"build-2803163510"},"reference-count":40,"publisher":"Elsevier BV","issue":"3","license":[{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["ajog.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["American Journal of Obstetrics and Gynecology"],"published-print":{"date-parts":[[2022,9]]},"DOI":"10.1016\/j.ajog.2022.03.050","type":"journal-article","created":{"date-parts":[[2022,3,26]],"date-time":"2022-03-26T19:52:02Z","timestamp":1648324322000},"page":"430-439.e5","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":22,"title":["Fetal reduction of triplet pregnancies to twins vs singletons: a meta-analysis of survival and pregnancy outcome"],"prefix":"10.1016","volume":"227","author":[{"given":"Kamran","family":"Hessami","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark I.","family":"Evans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed A.","family":"Nassr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimmy","family":"Espinoza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roopali V.","family":"Donepudi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena Sanz","family":"Cortes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eyal","family":"Krispin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shayan","family":"Mostafaei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Belfort","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6333-3177","authenticated-orcid":false,"given":"Alireza A.","family":"Shamshirsaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ajog.2022.03.050_bib1","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1056\/NEJM198804213181607","article-title":"Selective reduction of multifetal pregnancies in the first trimester","volume":"318","author":"Berkowitz","year":"1988","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.ajog.2022.03.050_bib2","first-page":"289","article-title":"Selective first-trimester termination in octuplet and quadruplet pregnancies: clinical and ethical issues","volume":"71","author":"Evans","year":"1988","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.ajog.2022.03.050_bib3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S1085-6862(97)00035-6","article-title":"The introduction of new technologies","volume":"2","author":"Evans","year":"1997","journal-title":"ACOG Clin Rev"},{"key":"10.1016\/j.ajog.2022.03.050_bib4","first-page":"1","article-title":"Births: preliminary data for 2015","volume":"65","author":"Hamilton","year":"2016","journal-title":"Natl Vital Stat Rep"},{"key":"10.1016\/j.ajog.2022.03.050_bib5","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1097\/01.AOG.0000200045.91015.c6","article-title":"Pregnancy-related mortality among women with multifetal pregnancies","volume":"107","author":"MacKay","year":"2006","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.ajog.2022.03.050_bib6","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1067\/mob.2002.123989","article-title":"Demographic and obstetric factors influencing pregnancy outcome in twin gestations","volume":"186","author":"Tarter","year":"2002","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ajog.2022.03.050_bib7","doi-asserted-by":"crossref","first-page":"586.e1","DOI":"10.1016\/j.ajog.2013.10.005","article-title":"Healthcare expenses associated with multiple vs singleton pregnancies in the United States","volume":"209","author":"Lemos","year":"2013","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ajog.2022.03.050_bib8","doi-asserted-by":"crossref","first-page":"100521","DOI":"10.1016\/j.ajogmf.2021.100521","article-title":"Fetal reduction and twins","volume":"4","author":"Evans","year":"2022","journal-title":"Am J Obstet Gynecol MFM"},{"key":"10.1016\/j.ajog.2022.03.050_bib9","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1111\/j.1471-0528.2007.01639.x","article-title":"Intracardiac injection of potassium chloride as method for feticide: experience from a single UK tertiary centre","volume":"115","author":"Pasquini","year":"2008","journal-title":"BJOG"},{"key":"10.1016\/j.ajog.2022.03.050_bib10","doi-asserted-by":"crossref","first-page":"1875","DOI":"10.1093\/humrep\/14.7.1875","article-title":"Early transvaginal embryo aspiration: a safer method for selective reduction in high order multiple gestations","volume":"14","author":"Coffler","year":"1999","journal-title":"Hum Reprod"},{"key":"10.1016\/j.ajog.2022.03.050_bib11","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1016\/j.rbmo.2017.05.012","article-title":"Multifetal pregnancy reduction of triplets to twins compared with non-reduced triplets: a meta-analysis","volume":"35","author":"Zipori","year":"2017","journal-title":"Reprod Biomed Online"},{"key":"10.1016\/j.ajog.2022.03.050_bib12","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1186\/s12884-020-2815-4","article-title":"Pregnancy outcomes of dichorionic triamniotic triplet pregnancies after in\u00a0vitro fertilization-embryo transfer: multifoetal pregnancy reduction versus expectant management","volume":"20","author":"Cai","year":"2020","journal-title":"BMC Pregnancy Childbirth"},{"key":"10.1016\/j.ajog.2022.03.050_bib13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/2046-4053-4-1","article-title":"Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement","volume":"4","author":"Moher","year":"2015","journal-title":"Syst Rev"},{"key":"10.1016\/j.ajog.2022.03.050_bib14","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1007\/s10654-010-9491-z","article-title":"Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses","volume":"25","author":"Stang","year":"2010","journal-title":"Eur J Epidemiol"},{"key":"10.1016\/j.ajog.2022.03.050_bib15","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1002\/pd.2906","article-title":"Fetal reduction of triplet pregnancy: one or two?","volume":"32","author":"Kuhn-Beck","year":"2012","journal-title":"Prenat Diagn"},{"key":"10.1016\/j.ajog.2022.03.050_bib16","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1159\/000356170","article-title":"Trichorionic and dichorionic triplet pregnancies at 10-14 weeks: outcome after embryo reduction compared to expectant management","volume":"34","author":"Chaveeva","year":"2013","journal-title":"Fetal Diagn Ther"},{"key":"10.1016\/j.ajog.2022.03.050_bib17","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.ejogrb.2012.11.018","article-title":"Retain singleton or twins? Multifetal pregnancy reduction strategies in triplet pregnancies with monochorionic twins","volume":"167","author":"Li","year":"2013","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"10.1016\/j.ajog.2022.03.050_bib18","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/j.rbmo.2016.02.011","article-title":"Early fetal reduction of dichorionic triplets to dichorionic twin or singleton pregnancies: a retrospective study","volume":"32","author":"Lin","year":"2016","journal-title":"Reprod Biomed Online"},{"key":"10.1016\/j.ajog.2022.03.050_bib19","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1111\/1471-0528.13348","article-title":"Dichorionic triplet pregnancies: risk of miscarriage and severe preterm delivery with fetal reduction versus expectant management. Outcomes of a cohort study and systematic review","volume":"122","author":"Morlando","year":"2015","journal-title":"BJOG"},{"key":"10.1016\/j.ajog.2022.03.050_bib20","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1515\/jpm-2016-0058","article-title":"Multi-fetal pregnancy reduction (MFPR) to twins or singleton - medical justification and ethical slippery slope","volume":"45","author":"Drugan","year":"2017","journal-title":"J\u00a0Perinat Med"},{"key":"10.1016\/j.ajog.2022.03.050_bib21","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.tjog.2018.11.025","article-title":"Clinical outcomes of multifetal pregnancy reduction in trichorionic and dichorionic triplet pregnancies: a retrospective observational study","volume":"58","author":"Liu","year":"2019","journal-title":"Taiwan J Obstet Gynecol"},{"key":"10.1016\/j.ajog.2022.03.050_bib22","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/j.rbmo.2019.12.014","article-title":"Pregnancy\u00a0outcome after multifetal pregnancy reduction of triplets to twins versus reduction to singletons","volume":"40","author":"Zemet","year":"2020","journal-title":"Reprod Biomed Online"},{"key":"10.1016\/j.ajog.2022.03.050_bib23","article-title":"Effects of the timing of selective reduction and finishing number of fetuses on the perinatal outcome in triplets: a single-center retrospective study","author":"Yan","year":"2020","journal-title":"J\u00a0Matern Fetal Neonatal Med"},{"key":"10.1016\/j.ajog.2022.03.050_bib24","first-page":"307","article-title":"Trichorionic triplet pregnancies at 10-14 weeks: outcome after embryo reduction compared to expectant management","volume":"11","author":"Papageorghiou","year":"2002","journal-title":"J\u00a0Matern Fetal Neonatal Med"},{"key":"10.1016\/j.ajog.2022.03.050_bib25","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1080\/jmf.16.4.219.222","article-title":"Embryo reduction versus expectant management in triplet pregnancies","volume":"16","author":"Antsaklis","year":"2004","journal-title":"J\u00a0Matern Fetal Neonatal Med"},{"key":"10.1016\/j.ajog.2022.03.050_bib26","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1007\/s10815-011-9651-4","article-title":"Obstetric outcomes of IVF trichorionic triamniotic triplets which are spontaneously or electively reduced to twins","volume":"28","author":"Ata","year":"2011","journal-title":"J\u00a0Assist Reprod Genet"},{"key":"10.1016\/j.ajog.2022.03.050_bib27","first-page":"745","article-title":"Fetal reduction in triplet gestations: twins still fare better","volume":"15","author":"Drugan","year":"2013","journal-title":"Isr Med Assoc J"},{"key":"10.1016\/j.ajog.2022.03.050_bib28","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1111\/ajo.12225","article-title":"Comparison of the outcomes between reduced\u00a0and nonreduced triplet pregnancies achieved by assisted reproductive technology","volume":"54","author":"Shiva","year":"2014","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"10.1016\/j.ajog.2022.03.050_bib29","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1016\/j.rbmo.2014.09.003","article-title":"Pregnancy outcome of early multifetal pregnancy reduction: triplets to twins versus triplets to singletons","volume":"29","author":"Haas","year":"2014","journal-title":"Reprod Biomed Online"},{"key":"10.1016\/j.ajog.2022.03.050_bib30","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1007\/s00404-014-3175-y","article-title":"A\u00a0comparative study of obstetric outcomes in electively or spontaneously reduced triplet pregnancies","volume":"290","author":"Okyay","year":"2014","journal-title":"Arch Gynecol Obstet"},{"key":"10.1016\/j.ajog.2022.03.050_bib31","doi-asserted-by":"crossref","first-page":"536.e1","DOI":"10.1016\/j.ajog.2014.04.023","article-title":"The effectiveness of multifetal pregnancy reduction in trichorionic triplet gestation","volume":"211","author":"Van De Mheen","year":"2014","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ajog.2022.03.050_bib32","doi-asserted-by":"crossref","first-page":"3075","DOI":"10.1080\/14767058.2017.1363733","article-title":"Outcome of dichorionic triamniotic triplet: the experience from an emerging fetal therapy center","volume":"31","author":"Sun","year":"2018","journal-title":"J\u00a0Matern Fetal Neonatal Med"},{"key":"10.1016\/j.ajog.2022.03.050_bib33","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1055\/s-0037-1603969","article-title":"Multifetal pregnancy reduction of trichorionic triplet gestations: what is the benefit?","volume":"34","author":"Herlihy","year":"2017","journal-title":"Am J Perinatol"},{"key":"10.1016\/j.ajog.2022.03.050_bib34","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.ejogrb.2021.07.021","article-title":"Expectant management versus multifetal pregnancy reduction in dichorionic triamniotic (DCTA) triplets: single centre experience","volume":"264","author":"Shaw","year":"2021","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"10.1016\/j.ajog.2022.03.050_bib35","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.ejogrb.2021.11.001","article-title":"Expectant management of triplets or multifetal reduction to twins; comparison of preterm delivery and live birth rates","volume":"268","author":"Karamustafaoglu Balci","year":"2022","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"10.1016\/j.ajog.2022.03.050_bib36","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1111\/aogs.14281","article-title":"Short-term and long-term outcomes of trichorionic triplet pregnancies with expectant management","volume":"101","author":"Lee","year":"2022","journal-title":"Acta Obstet Gynecol Scand"},{"key":"10.1016\/j.ajog.2022.03.050_bib37","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1097\/01.AOG.0000128299.57908.90","article-title":"Fetal reduction from twins to a singleton: a reasonable consideration?","volume":"104","author":"Evans","year":"2004","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.ajog.2022.03.050_bib38","doi-asserted-by":"crossref","first-page":"406.e1","DOI":"10.1016\/j.ajog.2008.06.017","article-title":"Contemporary outcomes with the latest 1000\u00a0cases of multifetal pregnancy reduction (MPR)","volume":"199","author":"Stone","year":"2008","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ajog.2022.03.050_bib39","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1159\/000357974","article-title":"Fetal reduction: 25 years\u2019 experience","volume":"35","author":"Evans","year":"2014","journal-title":"Fetal Diagn Ther"},{"key":"10.1016\/j.ajog.2022.03.050_bib40","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1002\/pd.4213","article-title":"Detection of genetic abnormalities by using CVS and FISH prior to fetal reduction in sonographically normal appearing fetuses","volume":"33","author":"Rosner","year":"2013","journal-title":"Prenat Diagn"}],"container-title":["American Journal of Obstetrics and Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0002937822002290?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0002937822002290?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T11:38:17Z","timestamp":1757590697000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0002937822002290"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9]]},"references-count":40,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,9]]}},"alternative-id":["S0002937822002290"],"URL":"https:\/\/doi.org\/10.1016\/j.ajog.2022.03.050","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.742303485.793595885","asserted-by":"object"}]},"ISSN":["0002-9378"],"issn-type":[{"value":"0002-9378","type":"print"}],"subject":[],"published":{"date-parts":[[2022,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Fetal reduction of triplet pregnancies to twins vs singletons: a meta-analysis of survival and pregnancy outcome","name":"articletitle","label":"Article Title"},{"value":"American Journal of Obstetrics and Gynecology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ajog.2022.03.050","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2022 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}