Saúde mental e abortamento voluntário na audiência pública da ADPF442/STF / Mental health and voluntary abortion in the public hearing of ADPF442/STF / Salud mental y aborto voluntario en la audiencia pública del ADPF442/STF

O estudo teve como objetivo identificar os argumentos da estratégia de persuasão dos discursos apresentados na audiência pública sobre a Arguição de Descumprimento de Preceito Fundamental-ADPF 442, realizada em 2018, cujo propósito era discutir sobre a interrupção voluntária da gravidez até a 12ª semana. Para tal, foi realizada uma pesquisa de abordagem qualitativa, analítico-descritiva e documental. O objeto de análise foi o registro da audiência, apresentado em vídeo, disponibilizado na plataforma digital YouTube, e em ata lavrada pelo STF, ambos de acesso público. A partir de uma análise do discurso, identificou-se os argumentos utilizados na estratégia de persuasão, que foram sistematizados em quatro categorias de argumentos para cada um dos dois grupos identificados: o grupo pró e o grupo contra a descriminalização do aborto. As três primeiras categorias, Saúde mental, Direito e Saúde pública, mesmo com diferenças na forma de apresentar o argumento, se repetem nos dois grupos. Todavia, a quarta categoria, Pressupostos, se diferenciou. No grupo pró descriminalização do aborto, apresentou-se como Pressupostos filosóficos e científicos, e no grupo contra, como Pressupostos morais. Por fim, a defesa da saúde mental das mulheres foi o principal argumento numa forma de humanizar o sofrimento vivido pelas que desejam abortar e não encontram o suporte do Estado para assegurar sua dignidade, cidadania e efetiva igualdade, garantidas constitucionalmente.(AU)

The study aimed to identify the arguments of the persuasion strategy of the speeches presented at the public hearing on the Action Against the Violation of Constitutional Fundamental Rights -ADPF 442, held in 2018, whose purpose was to discuss the voluntary interruption of pregnancy until the 12th week. To this end, a qualitative, analytical-descriptive, and documentary research was carried out. The object of analysis was the video recording of the hearing available on the YouTube platform, and in minutes drawn up by the STF, both of which are public. Based on a discourse analysis, the arguments used in the persuasion strategy were identified, which were systematized into four categories of arguments for each of the two identified groups: the group for and the group against the decriminalization of abortion. The first three categories, Mental Health, Law and Public Health, even with differences in the way of presenting the argument, are repeated in both groups. However, the fourth category, Assumptions, differed. In the group for the decriminalization of abortion, it was presented as Philosophical and Scientific Assumptions, whereas the group against, as Moral Assumptions. Finally, the defense of women's mental health was the main argument in a way of humanizing the suffering experienced by those who wish to have an abortion and do not find the support of the State to guarantee their dignity, citizenship, and effective equality, constitutionally guaranteed.(AU)

El estudio tuvo como objetivo identificar los argumentos de la estrategia de persuasión de los discursos presentados en la audiencia pública sobre el Argumento por Incumplimiento de un Percepto Fundamental -ADPF 442, realizada en 2018, con el objetivo de discutir la interrupción voluntaria del embarazo hasta la 12.ª semana. Para ello, se llevó a cabo una investigación cualitativa, analítico-descriptiva y documental. El objeto de análisis fue la grabación de la audiencia, que está disponible en la plataforma digital YouTube, y actas levantadas por el Supremo Tribunal Federal -STF, ambas de acceso público. A partir de un análisis del discurso se identificaron los argumentos utilizados en la estrategia de persuasión, los cuales se sistematizaron en cuatro categorías de argumentos para cada uno de los dos grupos identificados: el grupo pro y el grupo en contra de la despenalización del aborto. Las tres primeras categorías ("salud mental", "derecho" y "salud pública") aún con diferencias en la forma de presentar el argumento se repiten en ambos grupos. Pero difiere la cuarta categoría "supuestos". En el grupo a favor de la despenalización del aborto se presentó como "supuestos filosóficos y científicos", y en el grupo en contra, como "supuestos morales". Finalmente, la defensa de la salud mental de las mujeres fue el principal argumento en un intento por humanizar el sufrimiento que viven aquellas que desean abortar y no encuentran el apoyo del Estado para garantizar su dignidad, ciudadanía e igualdad efectiva, preconizadas por la Constitución.(AU)

Application of a modified Poisson model in identifying factors associated with prevalence of pregnancy termination among women aged 15 ­ 49 years in Uganda

Background: Abortion in Uganda is illegal, only permitted when it places the pregnant mother at risk. This study aimed to apply the modified Poisson model in identifying factors associated with the prevalence of pregnancy termination among women of reproductive age in Uganda. Methods: The 2016 Uganda Demographic Health Survey (UDHS) data were used in this study. More than 18,000 women of the age of 15 ­ 49 years participated in this study. A modified Poisson model that incorporated sampling weights was used to establish the factors associated with pregnancy termination. Results: In Uganda, 18,506 (18.1%) had ever had a pregnancy terminated. The results revealed that, the woman's age [APR = 3.15, 95% CI: 2.72-3.63], being married [APR = 1.55, 95% CI: 1.40-1.71], mass media exposure [APR = 1.18, 95% CI: 1.08-1.29], working status [APR = 1.21, 95% CI: 1.09-1.35], and having visited a health facility [APR = 1.20, 95% CI: 1.10-1.31] were positively significantly associated with likelihood of pregnancy termination. Conclusion: There exists a significant proportion of women who have had their pregnancies terminated in Uganda. It is observed that woman's age, marital status, mass media exposure, having visited a health facility in the last 12 months and working status were main predictors. Based on these results, researchers concluded that the emphasis should be put on improving access to post-abortion care, contraceptive use and media exposure

Reducción embrionaria en embarazo gemelar / Embryo reduction in twin pregnancy

La reducción embrionaria es la interrupción selectiva del desarrollo de uno o varios fetos en el primer trimestre del embarazo. El embarazo gemelar se presenta aproximadamente en uno de cada 100 nacimientos y se considera como una entidad con alto riesgo materno y fetal. Los embarazos múltiples tienen un impacto mayor en los sistemas de salud, debido a la mayor frecuencia de complicaciones. La rotura prematura de membranas causa aproximadamente el 40 por ciento de los partos pretérmino y, como consecuencia, aportan un 10 por ciento de la mortalidad perinatal según la Sociedad Española de Ginecología y Obstetricia. En este caso clínico se observó que una actitud expectante con los pertinentes controles ecográficos (índice del líquido amniótico), analíticos (recuento leucocitario y reacción en cadena de la polimerasa) y clínicos (frecuencia cardiaca y temperatura) pueden llevar a una buena evolución posnatal que justificó al menos en esta ocasión, una actitud conservadora(AU)

Embryonic reduction is the selective interruption of the development of one or several fetuses in the first trimester of pregnancy. Twin pregnancy occurs in approximately one in every 100 births. It is considered an entity with high maternal and fetal risk. Multiple pregnancies have greater impact on health systems due to the higher frequency of complications. Premature rupture of membranes causes approximately 40 percent of preterm births and, consequently, it contributes 10 percent of perinatal mortality according to the Spanish Society of Gynecology and Obstetrics. In this clinical case it was observed that an expectant attitude with the relevant ultrasound (index of amniotic fluid), analytical (leukocyte count and polymerase chain reaction) and clinical (heart rate and temperature) controls can lead to good postnatal evolution, justified at least on this occasion, a conservative attitude(AU)

Experience of Decision Making about Selective Fetal Reduction among Women Who Conceived through Assisted Reproductive Techniques / 임상간호연구

PURPOSE: This study aimed to explore and understand the experience of decision making among women undergoing or forgoing selective fetal reduction who have higher-order multiple pregnancies through assisted reproductive techniques. METHODS: A qualitative study was conducted from August 1, to October 30, 2013. Eight participants were interviewed and the interviews were audio-recorded and transcribed verbatim. Six persons participated in in-depth interviews in person and two participated over the telephone. A thematic analysis was conducted. RESULTS: Four themes were identified and carefully named: Confusion after higher-order multiple pregnancy; Obstacles to choice: Uncertain safety; Weighing between reality and ideality and; Influences of medical professionals. CONCLUSION: The results demonstrated a wide range of factors considered by women when making decisions about selective fetal reduction, and mothers'feelings of conflict and distress in the decision-making process. The results suggest that it is important for nurses to provide emotional support and consolation, in addition to sufficient information. These findings will help nurses improve their counseling techniques by understanding the situation of infertile couples.

Thanatophoric dysplasia in a dichorionic twin confirmed by genetic analysis at the early second trimester: A case report and literature review

Thanatophoric dysplasia (TD) is caused by mutation of the gene that encodes fibroblast growth factor 3 (FGFR3). Owing to the poor prognosis for TD, prenatal diagnosis is critical to optimal perinatal management. We report here a case of TD in twin pregnancy, which was prenatally diagnosed by DNA analysis following amniocentesis at 15 weeks, and was managed by selective fetal termination. Prenatal ultrasonography and molecular analysis to detect TD-specific mutations enable accurate diagnosis of FGFR3-related TD in utero and appropriate obstetrical management at early gestation during twin pregnancy.

Fetal reduction by bipolar cord coagulation in managing complicated monochorionic multiple pregnancies: preliminary experience in China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Monochorionic multiple pregnancies (MMPs) are associated with higher rates of perinatal morbidity and mortality caused by interfetal vascular anastomoses in the monochorionic placenta, which can lead to fetal health interactions. In some circumstances, selective feticide of the affected fetus is necessary to save the healthy co-twin. We evaluated the effects and safety of our initial experiences using bipolar cord coagulation for the management of complicated MMPs.</p><p><b>METHODS</b>Using ultrasound-guided bipolar cord coagulation, we performed selective feticide on 14 complicated MMPs (5 with twin-twin transfusion syndrome, 4 with acardia, 3 with discordant structural anomalies, and 2 with severe selective intrauterine growth restriction). One patient with monochorionic triplets received the procedure twice to terminate 2 affected fetuses for different indications. Data regarding the operations, complications and neonatal outcomes were analyzed.</p><p><b>RESULTS</b>Cord occlusions were successfully performed in 13/14 (93%) cases. The failure happened in an acardiac fetus and the pregnancy was terminated by induction. The included cases delivered at a mean gestational age of 35.4 weeks with a perinatal survival rate of 11/13 (85%). Three operation-related complications occurred (21%), including membrane rupture of the terminated sac (1 case), preterm labor at 28 weeks gestation (1 case), and chorioamniotic membrane separation (1 case). Amnioinfusion was indicated in 11 procedures to expand the target sacs for entering the trocar and obtaining sufficient working space. However, in all 4 cases of acardia, the acardiac sacs showed extreme oligohydramnios and could not be well expanded by infusion; thus, the trocar had to be inserted from the sac of the preserved co-twin.</p><p><b>CONCLUSIONS</b>The application of bipolar cord coagulation in complicated MMPs is safe and improves the prognosis. Amnioinfusion is useful in helping to expand the target sac when the working space is limited.</p>

Ethical aspects of multiple pregnancy

The rate of multiple pregnancy has dramatically increased during the past decades, along with the diffusion of assisted reproduction technology [ART]. Multiple pregnancy entail an increased risk of, at times life threatening, maternal complications i.e. pre-eclampsia, eclampsia or abruptio placenta, of serious neonatal hazards, i.e. extreme prematurity or growth retardation, as well as deleterious impact on family and social life. It raises the ethical debate of fetal reduction. The international federation of gynaecologists and obstetricians [FIGO] recommendations on iatrogenic multiple pregnancy emphasizes the need for the transfer of a limited number of embryos during ART in order to secure a singleton pregnancy

Assisted reproductive technology in Saudi Arabia

This paper aims at presenting details of the application of assisted reproductive technology and the impact of the Islamic law [Sharia] on its practice in the Kingdom of Saudi Arabia [KSA]. Analysis of the data sourced from manual searches of bibliographies from key articles showed that this technology in KSA is practiced in a strictly religious manner and certain aspects of the technology are completely forbidden. It further showed that lack of an official government in-vitro fertilization [IVF] registry to gather information on the activities of IVF clinics has limited the data available for international comparisons. Sharing information internationally could allow religiously concerned infertile couples to have access to the reproductive services in the Kingdom. It would further improve the quality of care, enhance certain techniques like in-vitro maturation and experimentation on embryos, by providing resources that are currently unavailable, keeping in view the religious beliefs and avoiding conflicts

Perinatal outcome after multifetal pregnancy reduction.

OBJECTIVE: To assess multifetal pregnancy reduction in Indian context. METHODS: It is a retrospective descriptive study. Perinatal outcome of 92 multifetal pregnancies were retrieved from a well maintained database. Fetal reductions were carried out using standard protocol. RESULTS: There were 92 pregnancies referred for fetal reduction during the study period. Out of 92, twelve pregnancies (20.3%) had fetal or neonatal losses; of which complete pregnancy loss rate was 8.5% and partial pregnancy loss rate was 11.8%. Twenty one (35.6%) pregnancies had premature deliveries. The median birth weight was 2100 grams. Four babies were born alive with congenital anomalies. CONCLUSION: Our study showed the median birth weight, rates of pregnancy loss and prematurity after the fetal reduction procedure was comparable with other studies. However, it must be noted that the rate of loss to follow up was higher in our study.

Pregnancy Outcomes of Different Methods for Multifetal Pregnancy Reduction: A Comparative Study

The purpose of this study was to evaluate the outcomes of various methods of multifetal pregnancy reduction (MFPR) and to determine which method produces better outcomes. One hundred and forty-eight patients with multiple pregnancies resulting from assisted reproduction programs and underwent MFPR were included. According to the use of potassium chloride (KCl), patients were divided into 'KCl', and 'non- KCl' groups, and based on gestational age at the time of procedures, patients were divided into 'Early' (before 8 weeks of gestation) and 'Late' (at 8 weeks or later) groups. Firstly, to clarify the effect of each component of MFPR procedure, data were analyzed between 'KCl' and 'non-KCl' groups, and between 'Early' and 'Late' groups with adjustments. Secondly, comparison between 'Early, non-KCl' and 'Late, KCl' groups was performed to evaluate the combinative effect of both components. Non-KCl groups showed a significantly higher take-home-baby rate, and lower risk of extreme prematurity and preterm premature rupture of membranes (PPROM) than KCl groups. Early groups showed a lower immediate loss rate than Late groups. As compared with 'Late, KCl' group, 'Early, non-KCl' group was superior in terms of immediate loss, pregnancy loss, take-home-baby, and PPROM rates. Our data suggest that the 'Early, non-KCl' method may be a better option for MFPR.

Twin reverse arterial perfusion sequence

Twin reverse arterial perfusion sequence occurs in approximately one percent of monochorionic twins. This condition is always fatal for the recipient twin and carries a high mortality rate for the pump twin. Various treatment options are described, but management is continually evolving with the publication of new data. We report an acardiac acephalic monochorionic twin who was diagnosed at 31 weeks gestation. Serial ultrasonographical examinations of the normal pump twin showed intrauterine growth restriction but with no evidence of heart failure. A healthy pump twin was delivered by caesarean section at 34 weeks.

Comparison of twin pregnancy outcome after assisted reproductive technology with and without embryo reduction

Spontaneous occurrences of multifetal pregnancies always have been a medical problem. The risks of perinatal morbidity and mortality and maternal morbidity increase with enhancement of the number of fetuses. In our prospective experimental study, the outcome of twin pregnancy after Assisted Reproductive Technologies [ART] with and without Multifetal Pregnancy Reduction [MFPR] is compared relating to perinatal and maternal complications. The aim of this study was to compare the gestational age at delivery, birth weight, and other complications of surviving twins following MFPR to those in a control group of non-reduced twins. In this prospective experimental study, from infertile couples who were referred to Isfahan Fertility- Infertility Center [IFIC] and were candidate for ART [Invitro Fertilization or Intra Cytoplasmic Sperm Injection], 30 couples who have had twin [control group] and 35 couples with quadruplet or higher order pregnancies [experimental group] were selected. In cases with experimental group MFPR was done, and pregnancy outcome-miscarriage, premature labor, Premature Preterm Rupture of Membranes [PPROM] and Pregnancy Induced Hypertension [PIH]-were compared between two groups. Distribution of complications in experimental vs. control groups was as follows: miscarriage: 23.3 vs. 16 .7%, premature labor: 15.7% vs. 13.3%, pregnancy induced hypertension: 13.3% vs. 16.7%, abruption: 6.7% vs. 6.7%, and premature preterm rupture of membranes: 23.3% vs. 26.7%. Mean neonatal weight at birth [2239 vs. 2240 gr] and mean gestational age at delivery [33.5 vs. 34.1 w] were similar. The differences between two groups were not statistically significant [P>0.05]. MFPR during early pregnancy is a safe, effective and simple operative for the purpose of reducing perinatal and maternal complications

Acardiac twin.

Acardiac twin is a rare complication of monozygotic twin pregnancies occurring in 1% of monochorionic twin gestations with an incidence of 1 in 35,000 births. Without treatment, the perinatal mortality of the pump twin is about 50-70%. The optimal management of acardiac twin pregnancies is controversial. Management options include elective termination, observation with close antepartum surveillance (serial cardiotocography, ultrasonography and echocardiography) and surgical interventions

Comparative analysis of two methods of transvaginal multifetal pregnancy reduction / 中华男科学杂志

<p><b>OBJECTIVE</b>To make a comparatively analysis of the effects of 10% KCl injection into the fatal cardiac area and yolk-sac aspiration on multifetal pregnancy reduction.</p><p><b>METHODS</b>Twenty-three patients with multifetus were selected in the investigation. Eight of the patients accepted 10% KCl injection into the fatal cardiac area, and 15 of them received yolk-sac aspiration. The average number of punctures, average time of reduction operation, failure rate of operation, abortion rate, and infection rate were observed.</p><p><b>RESULTS</b>The average time of reduction operation[(2.8 +/- 0.7) min] of aspiration was significantly lower than that of 10% KCl injection [(5.11 +/- 1.35) min] (P < 0.05). The infection rate of yolk-sac aspiration was 6.7%, lower than that of 10% KCl injection (37.5%) (P > 0.05). Cardic area injection showed a higher infection rate, and no significant difference was observed in the average number of punctures, failure rate of operation and abortion rate(P > 0.05).</p><p><b>CONCLUSION</b>Although both yolk-sac aspiration and cardiac area injection were safe and reliable methods for multifetal pregnancy reduction, the former is worth recommending for its shorter operation time heeded and lower infection rate, especially for the multifetal patients within 60 gestation days.</p>

Multigestación como marcador de eficiencia reproductiva. Enseñanzas de la reproducción asistida / Multigestation like marker of reproductive efficiency. Lessons of the attended reproduction

El objetivo de este estudio fue evaluar el devenir de embriones que cohabitan en una multigestación luego de reproducción asistida (RA). Se utilizaron las tasas de reducción embrionaria espontánea como marcador de fecundidad humana. Es un estudio caso-control. Grupo de estudio: 162 mujeres embarazadas luego de un procedimiento de reproducción asistida (RA); Grupo Control A: 344 mujeres fértiles que concibieron en forma espontánea; Grupo Control B: 317 mujeres infértiles que concibieron un embarazo único luego de un procedimiento de RA. En casos y controles se evaluaron las siguientes variables: tasa de implantación, tasa de reducción embrionaria espontánea parcial y total (aborto) y tasa global de reducción embrionaria. Los resultados demuestran que el devenir de cada embrión que cohabita en una multigestación sigue un patrón similar a la de un embrión concebido en forma espontánea en mujeres fértiles. Es razonable pensar que ovocitos de estas mujeres son de mejor calidad y por ende son capaces de producir mejores embriones que las mujeres que, a pesar de concebir, tienen tasas de implantación más bajas, como son las del grupo de control B. El desafío futuro es identificar marcadores de eficiencia reproductiva que pueden ser usados en la prevención de embarazo múltiple.

Outcome of Twin Pregnancies after Selective Fetal Reduction / 대한불임학회지

OBJECTIVES: To evaluate the safety and efficacy of selective fetal reduction (SFR) and compare the outcome of twin pregnancy after SFR in multiple pregnancy induced by assisted reproductive technology (ART) with that of natural twin pregnancy. METHODS: From September 1995 to March 2002 in Ajou University Hospital, SFR was performed in 79 patients whose gestational sacs were more than 3. Of these 79 patients, 47 patents resulted in twin pregnancy after SFR. SFR was performed using transvaginal intracardiac KCl injection at gestational age of 6~9 weeks. Control group was composed of 264 patients with natural twin pregnancy, who delivered after intrauterine pregnancy at 24 weeks, from June 1994 through December 2002. We compared Obstetric and perinatal outcomes between SFR group and natural twin group. RESULTS: Among 47 patients with twin pregnancy after SFR, 2 spontaneous abortion were occurred at intrauterine pregnancy at 8 and 19 weeks. Obstetrical and perinatal outcomes were available in 43 patients. Single intrauterine fetal death was occurred in 1 of 43 (2.3%) patients in SFR group. incidence of preterm labor, premature rupture of membrane, preeclampsia and placenta previa were similar, but gestational diabetes mellitus (GDM) was occurred more frequently in SFR group (3 (7.0%) vs 4 (1.5%), p=0.02). Mean gestational age, mean birth weight, incidence of discordancy, use of intubation and ventilation, incidence of fetal anomaly, low (<7) Apgar score and intrauterine growth restriction were similar in both groups. CONCLUSION: Twin pregnancy after SFR has the increased incidence for GDM but other obstetric and perinatal outcome was similar compared with natural twin pregnancy. So SFR is a safe and effective procedure, so we suggest SFR is needed in multifetal pregnancy more than triplet.

Successful Full-term Live Birth after Selective Fetal Reduction Procedure in Patient with Heterotopic Cornual Pregnancy / 대한산부인과학회잡지

Heterotopic pregnancy refers to the simultaneous occurrence of an ectopic gestation with an intrauterine one. The incidence of heterotopic pregnancy in the general population is about 1 to 30,000 pregnancies, but it has been increased due to the rise in pelvic inflammatory disease (PID), pelvic surgery, intrauterine device (IUD), and assisted reproductive technologies (ART), such as in vitro fertilization and embryo transfer (IVF-ET). However, an interstitial or cornual pregnancy accounts for only 2-4% of all tubal pregnancies and has been described only rarely in the setting of a heterotopic pregnancy. We have experienced a case of heterotopic pregnancy with cornual pregnancy after IVF-ET which was successfully treated by selective fetal reduction (SFR) procedure while maintaining the viability of the intrauterine gestation. We presented with brief review of literatures.

Factors Affecting Complete Fetal Loss Following Multifetal Pregnancy Reduction / 대한불임학회지

OBJECTIVE: To identify the factors affecting the complete fetal loss following multifetal pregnancy reduction (MFPR). DESiGN: Retrospective clinical study. METHODS: A total of 256 consecutive treatments of MFPR in iVF-ET cycles performed between 1992 through 2000 in Samsung Cheil hospital were analyzed. MFPR was done around 8 weeks of gestation by transvaginal ultrasono-guided aspiration in multiple pregnancies and reduced to singleton or twins. Stepwise logistic regression was performed to identify the factors affecting the final outcome of pregnancy after MFPR. Dependent variable was complete fetal loss and the independent variables were maternal age, paternal age, initial number of gestational sac (iGSNO), initial number of fetal heart beat, the number of remaining live fetus after MFPR, and chorionicity. RESULTS: The total survival rate was 87.9%, and total fetal loss rate after MFPR was 12.1%. Total fetal loss occurred within four weeks from MFPR procedure was 1.95%. Total loss occurred after four weeks of procedure and before 24 gestational weeks was 8.2%. Seventy nine percent (202/256) of pregnancies delivered after 34 weeks of gestation. The survival rate of pregnancies reduced to singleton was significantly higher than that of pregnancies reduced to twins (93.5% vs. 86.7%, p<0.05). The mean (+/-SEM) gestational age at delivery was 36.2+/-1.0 and 34.1+/-0.5 weeks for pregnancies reduced to singletons and twins, respectively (p=0.065). Logistic regression analysis revealed that the maternal age, the number of initial gestational sac (iGSNO), and the number of remaining live fetus after MFPR significantly affected the rate of total fetal loss (Z = 0.174'age + 0.596'iGSNO + 1.324'remaining fetuses-12.07), (p<0.05). CONCLUSiONS: MFPR seems to be a relatively safe and efficient method to improve the obstetric outcome in high order multiple pregnancy. Because the maternal age, the number of initial gestational sac and the remaining live fetuses after MFPR affect the total fetal loss rate, restriction of the number of transferred embryos according to the age and MFPR to singleton fetus could be considered for the better obstetric outcome in iVF pregnancy.

Clinical analysis of multiple pregnancy reduction / 中华男科学杂志

<p><b>OBJECTIVE</b>To analyse the effect of the reduction of multiple pregnancy through transvaginal ultrasonic monitoring on the pregnancy outcome.</p><p><b>METHODS</b>Eighty-four cases were divided into two groups according to whether they had vaginal hemorrhage before operation. And the pregnancy outcomes were analyzed.</p><p><b>RESULTS</b>The abortion rate and preterm birth rate of the vaginal hemorrhage group were higher, and the difference was statistically significant.</p><p><b>CONCLUSIONS</b>The reduction of multiple pregnancy through transvaginal ultrasonic monitoring is a safe operative method. But it is only a remedial treatment for multiple pregnancy, and how to prevent multiple pregnancy is of more practical value.</p>