{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T15:13:21Z","timestamp":1775142801762,"version":"3.50.1"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,7,3]],"date-time":"2020-07-03T00:00:00Z","timestamp":1593734400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,7,3]],"date-time":"2020-07-03T00:00:00Z","timestamp":1593734400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pregnancy Childbirth"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>There are still some controversies regarding the risks and benefits of fetal reduction from twins to singletons. We aimed to evaluate if fetal reduction from twins to singleton improves pregnancy outcome.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Retrospective analysis of all dichorionic-diamniotic twin pregnancies, who underwent fetal reduction. Pregnancy outcome was compared to ongoing, non-reduced, dichorionic-diamniotic gestations. Primary outcome was preterm birth prior to 37 gestational weeks. Secondary outcomes included: preterm birth prior to 34 gestational weeks, gestational age at delivery, birthweight, small for gestational age, hypertensive disorders, gestational diabetes and stillbirth.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Ninety-eight reduced pregnancies were compared with 222 ongoing twins. Preterm birth &lt;\u200937 gestational weeks (39.6% vs. 57.6%, <jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.001) was significantly lower in the reduced group compared to the ongoing twins\u2019 group. A multivariate analysis, controlling for parity and mode of conception, demonstrated that fetal reduction independently and significantly reduced the risk for prematurity (aOR 0.495, 95% CI -0.299-0.819). Subgroup analysis, similarly adjusted demonstrated lower rates of preterm delivery in those undergoing elective reduction (aOR\u2009=\u20090.206, 95% CI 0.065\u20130.651), reduction due to fetal anomalies (aOR\u2009=\u20090.522, 95% CI 0.295\u20130.926) and 1st trimester reduction (aOR\u2009=\u20090.297, 95% Cl 0.131\u20130.674) all compared to ongoing twins.<\/jats:p>\n<jats:p>A Kaplan-Meier survival curve showed a significant proportion of non-delivered women at each gestational week in the reduced group compared to non-reduced twins, after 29 gestational weeks.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Fetal reduction from twins to singleton reduces the risk of preterm birth &lt;\u200937 gestational weeks, but not for more severe maternal and perinatal complications.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12884-020-03076-7","type":"journal-article","created":{"date-parts":[[2020,7,3]],"date-time":"2020-07-03T09:05:05Z","timestamp":1593767105000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Pregnancy outcome following fetal reduction from dichorionic twins to singleton gestation"],"prefix":"10.1186","volume":"20","author":[{"given":"Gal","family":"Greenberg","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ron","family":"Bardin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shir","family":"Danieli-Gruber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kinneret","family":"Tenenbaum-Gavish","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anat","family":"Shmueli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eyal","family":"Krispin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Galia","family":"Oron","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arnon","family":"Wiznitzer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3101-2827","authenticated-orcid":false,"given":"Eran","family":"Hadar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,7,3]]},"reference":[{"key":"3076_CR1","doi-asserted-by":"publisher","first-page":"1118","DOI":"10.1097\/01.AOG.0000446856.51061.3e","volume":"123","author":"American College of Obstetricians and Gynecologists, Society for Maternal-Fetal Medicine","year":"2014","unstructured":"American College of Obstetricians and Gynecologists, Society for Maternal-Fetal Medicine. 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The study has been approved by the local institutional review board at Rabin medical center (Approval No. 0861\u201317-RMC). Informed consent was waived due the retrospective design of the study.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Eran Hadar, the corresponding author for this manuscript, serves as a member of the editorial board for this journal (BMC Pregnancy and Childbirth associate editor). All other authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"389"}}