Multifetal reduction increases the risk of preterm delivery and fetal growth restriction in twins: A case-control study
To compare pregnancy outcome in twin gestations resulting from multifetal reduction to “primary” twin pregnancies derived from either spontaneous conception or infertility therapy. Case-control study. University-affiliated tertiary center. Multifetal pregnancies (quadruplets or more) reduced to twin...
Saved in:
Published in | Fertility and sterility Vol. 67; no. 1; pp. 30 - 33 |
---|---|
Main Authors | , , , , , |
Format | Journal Article Conference Proceeding |
Language | English |
Published |
New York, NY
Elsevier Inc
1997
Elsevier Science |
Subjects | |
Online Access | Get full text |
Cover
Loading…
Abstract | To compare pregnancy outcome in twin gestations resulting from multifetal reduction to “primary” twin pregnancies derived from either spontaneous conception or infertility therapy.
Case-control study.
University-affiliated tertiary center.
Multifetal pregnancies (quadruplets or more) reduced to twins (group A) compared with twin gestations conceived either spontaneously (group B) or through infertility therapy (group C).
Multifetal reduction for group A; perinatal care for groups A, B, and C.
Comparison of perinatal complications between groups including antepartum bleeding, premature membrane rupture, and preterm labor. Neonatal outcomes compared including gestational age at delivery, birth weight, incidence of fetal growth restriction, and twin discordancy.
A higher incidence of idiopathic preterm labor was noted in group A cases (14/18) compared with either of the control groups (B: 26/54, or C: 24/54). As a consequence, group A had the lowest gestational age at delivery (32.6 ± 3.9 weeks) compared with groups B (33.6 ± 4.4 weeks) and C (36.0 ± 3.4 weeks). Corresponding birth weights of both first- and second-born twins were significantly lower in group A compared with group C, whereas the birth weight comparison between groups A and B showed a nonsignificant difference. The proportion of pregnancies in which one or both twins weighed less than the 10th percentile was greatest in group A pregnancies (A: 5/18 versus C: 5/54). Discordant birth weight among twin pairs was proportionately greater for group A cases at both the 20% and 30% discordance levels.
Twin gestations resulting from multifetal reduction are at increased risk for preterm birth, fetal growth restriction, and discordancy when compared with fertility therapy-derived, nonreduced twins. |
---|---|
AbstractList | To compare pregnancy outcome in twin gestations resulting from multifetal reduction to “primary” twin pregnancies derived from either spontaneous conception or infertility therapy.
Case-control study.
University-affiliated tertiary center.
Multifetal pregnancies (quadruplets or more) reduced to twins (group A) compared with twin gestations conceived either spontaneously (group B) or through infertility therapy (group C).
Multifetal reduction for group A; perinatal care for groups A, B, and C.
Comparison of perinatal complications between groups including antepartum bleeding, premature membrane rupture, and preterm labor. Neonatal outcomes compared including gestational age at delivery, birth weight, incidence of fetal growth restriction, and twin discordancy.
A higher incidence of idiopathic preterm labor was noted in group A cases (14/18) compared with either of the control groups (B: 26/54, or C: 24/54). As a consequence, group A had the lowest gestational age at delivery (32.6 ± 3.9 weeks) compared with groups B (33.6 ± 4.4 weeks) and C (36.0 ± 3.4 weeks). Corresponding birth weights of both first- and second-born twins were significantly lower in group A compared with group C, whereas the birth weight comparison between groups A and B showed a nonsignificant difference. The proportion of pregnancies in which one or both twins weighed less than the 10th percentile was greatest in group A pregnancies (A: 5/18 versus C: 5/54). Discordant birth weight among twin pairs was proportionately greater for group A cases at both the 20% and 30% discordance levels.
Twin gestations resulting from multifetal reduction are at increased risk for preterm birth, fetal growth restriction, and discordancy when compared with fertility therapy-derived, nonreduced twins. To compare pregnancy outcome in twin gestations resulting from multifetal reduction to "primary" twin pregnancies derived from either spontaneous conception or infertility therapy. Case-control study. University-affiliated tertiary center. Multifetal pregnancies (quadruplets or more) reduced to twins (group A) compared with twin gestations conceived either spontaneously (group B) or through infertility therapy (group C). Multifetal reduction for group A; perinatal care for groups A, B, and C. Comparison of perinatal complications between groups including antepartum bleeding, premature membrane rupture, and preterm labor. Neonatal outcomes compared including gestational age at delivery, birth weight, incidence of fetal growth restriction, and twin discordancy. A higher incidence of idiopathic preterm labor was noted in group A cases (14/18) compared with either of the control groups (B: 26/54, or C: 24/54). As a consequence, group A had the lowest gestational age at delivery (32.6 +/- 3.9 weeks) compared with groups B (33.6 +/- 4.4 weeks) and C (36.0 +/- 3.4 weeks). Corresponding birth weights of both first- and second-born twins were significantly lower in group A compared with group C, whereas the birth weight comparison between groups A and B showed a nonsignificant difference. The proportion of pregnancies in which one or both twins weighted less than the 10th percentile was greatest in group A pregnancies (A: 5/18 versus C: 5/54). Discordant birth weight among twin pairs was proportionately greater for group A cases at both the 20% and 30% discordance levels. Twin gestations resulting from multifetal reduction are at increased risk for preterm birth, fetal growth restriction, and discordancy when compared with fertility therapy-derived, nonreduced twins. OBJECTIVETo compare pregnancy outcome in twin gestations resulting from multifetal reduction to "primary" twin pregnancies derived from either spontaneous conception or infertility therapy.DESIGNCase-control study.SETTINGUniversity-affiliated tertiary center.PATIENT(S)Multifetal pregnancies (quadruplets or more) reduced to twins (group A) compared with twin gestations conceived either spontaneously (group B) or through infertility therapy (group C).INTERVENTION(S)Multifetal reduction for group A; perinatal care for groups A, B, and C.MAIN OUTCOME MEASURE(S)Comparison of perinatal complications between groups including antepartum bleeding, premature membrane rupture, and preterm labor. Neonatal outcomes compared including gestational age at delivery, birth weight, incidence of fetal growth restriction, and twin discordancy.RESULT(S)A higher incidence of idiopathic preterm labor was noted in group A cases (14/18) compared with either of the control groups (B: 26/54, or C: 24/54). As a consequence, group A had the lowest gestational age at delivery (32.6 +/- 3.9 weeks) compared with groups B (33.6 +/- 4.4 weeks) and C (36.0 +/- 3.4 weeks). Corresponding birth weights of both first- and second-born twins were significantly lower in group A compared with group C, whereas the birth weight comparison between groups A and B showed a nonsignificant difference. The proportion of pregnancies in which one or both twins weighted less than the 10th percentile was greatest in group A pregnancies (A: 5/18 versus C: 5/54). Discordant birth weight among twin pairs was proportionately greater for group A cases at both the 20% and 30% discordance levels.CONCLUSION(S)Twin gestations resulting from multifetal reduction are at increased risk for preterm birth, fetal growth restriction, and discordancy when compared with fertility therapy-derived, nonreduced twins. |
Author | Helfand, Brian T. Russell, Tanya L. MacGregor, Scott N. Ragin, Ann Silver, Richard K. Sholl, John S. |
Author_xml | – sequence: 1 givenname: Richard K. surname: Silver fullname: Silver, Richard K. email: r-silver@nwu.edu – sequence: 2 givenname: Brian T. surname: Helfand fullname: Helfand, Brian T. – sequence: 3 givenname: Tanya L. surname: Russell fullname: Russell, Tanya L. – sequence: 4 givenname: Ann surname: Ragin fullname: Ragin, Ann – sequence: 5 givenname: John S. surname: Sholl fullname: Sholl, John S. – sequence: 6 givenname: Scott N. surname: MacGregor fullname: MacGregor, Scott N. |
BackLink | http://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2523248$$DView record in Pascal Francis https://www.ncbi.nlm.nih.gov/pubmed/8986679$$D View this record in MEDLINE/PubMed |
BookMark | eNqFkE1vEzEQhi1UVNLCT6jkA0JwWGp7116bC6oqPiq14gCcLWc8Sw0bO9jeRvn3bJqQa09zmOd9Z_SckZOYIhJywdl7zri6_M4Ylw0TWrw1_TvNteQNf0YWXErVSCXbE7I4Ii_IWSm_GWOK9-KUnGqjlerNgmzuprGGAasbaUY_QQ0p0hAhoytYaL1HmkP5Q9NA1xkr5hX1OIYHzFvqoqf76K-cNvV-big1h_8dtG5CLB_oFYW5q4EUa04jLXXy25fk-eDGgq8O85z8_Pzpx_XX5vbbl5vrq9sGJBO1UZ2GDjRCy1u9bCWXqNAsux51h1wz00HXLgcPMLhOG8G0aaVQenDaoxCsPSdv9r3rnP5O83t2FQrgOLqIaSq2173Zdc-g3IOQUykZB7vOYeXy1nJmd8Lto3C7s2lNbx-FWz7nLg4HpuUK_TF1MDzvXx_2roAbh-wihHLEhBSt6HbnP-4xnGU8BMy2QMAI6ENGqNan8MQj_wBWwqAt |
CODEN | FESTAS |
CitedBy_id | crossref_primary_10_1016_S0095_5108_03_00055_1 crossref_primary_10_1080_10641955_2023_2225597 crossref_primary_10_1097_00006254_200209003_00001 crossref_primary_10_1093_humrep_des193 crossref_primary_10_1097_AOG_0000000000004410 crossref_primary_10_1375_twin_4_6_422 crossref_primary_10_1016_S0015_0282_00_01544_2 crossref_primary_10_1097_AOG_0000000000004251 crossref_primary_10_1053_j_semperi_2008_02_004 crossref_primary_10_1097_00003081_200403000_00017 crossref_primary_10_3346_jkms_2008_23_1_111 crossref_primary_10_1016_S0015_0282_98_00027_2 crossref_primary_10_5005_jp_journals_10016_1080 crossref_primary_10_1016_S0095_5108_05_70025_7 crossref_primary_10_1016_j_fertnstert_2003_07_012 crossref_primary_10_1111_ajo_12225 crossref_primary_10_1016_S0002_9378_98_70276_5 crossref_primary_10_1080_14767058_2018_1461313 crossref_primary_10_1111_j_1552_6909_1998_tb02657_x crossref_primary_10_1016_j_tjog_2017_12_016 crossref_primary_10_1016_j_ajog_2003_07_027 crossref_primary_10_1016_S0002_9378_99_70544_2 crossref_primary_10_1067_mob_2002_124957 crossref_primary_10_1016_S0015_0282_99_00550_6 crossref_primary_10_1067_mob_2001_117683 crossref_primary_10_1016_S0140_6736_02_07283_5 crossref_primary_10_1053_plac_1999_0449 crossref_primary_10_1016_S0095_5108_18_30169_6 crossref_primary_10_1080_jmf_13_5_289_291 crossref_primary_10_1016_j_fertnstert_2011_01_029 crossref_primary_10_1016_j_fertnstert_2006_12_036 crossref_primary_10_1097_AOG_0000000000003070 |
Cites_doi | 10.1016/S0015-0282(16)57985-0 10.1111/j.1471-0528.1992.tb13734.x 10.1016/0002-9378(93)90124-2 10.1016/S0002-9378(12)90823-6 10.1016/0140-6736(90)90550-O 10.1016/1071-5576(95)00037-2 |
ContentType | Journal Article Conference Proceeding |
Copyright | 1997 American Society for Reproductive Medicine 1997 INIST-CNRS |
Copyright_xml | – notice: 1997 American Society for Reproductive Medicine – notice: 1997 INIST-CNRS |
DBID | IQODW CGR CUY CVF ECM EIF NPM AAYXX CITATION 7X8 |
DOI | 10.1016/S0015-0282(97)81851-1 |
DatabaseName | Pascal-Francis Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed CrossRef MEDLINE - Academic |
DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) CrossRef MEDLINE - Academic |
DatabaseTitleList | MEDLINE MEDLINE - Academic |
Database_xml | – sequence: 1 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: EIF name: MEDLINE url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search sourceTypes: Index Database |
DeliveryMethod | fulltext_linktorsrc |
Discipline | Medicine |
EISSN | 1556-5653 |
EndPage | 33 |
ExternalDocumentID | 10_1016_S0015_0282_97_81851_1 8986679 2523248 S0015028297818511 |
Genre | Journal Article |
GroupedDBID | --- --K -~X .1- .55 .FO .GJ 0R~ 1B1 1P~ 1~5 29H 34R 3O- 4.4 457 4G. 53G 5GY 5RE 5VS 7-5 71M 85S AACTN AAEDT AAEDW AAIAV AALRI AAQFI AAQXK AAXUO ABCQX ABFRF ABJNI ABLJU ABMAC ACGFO ACIUM ADBBV ADMUD ADPAM AEFWE AENEX AEVXI AFFNX AFRHN AFTJW AGZHU AHPSJ AI. AITUG AJUYK ALMA_UNASSIGNED_HOLDINGS ALXNB AMRAJ ASPBG AVWKF AZFZN BELOY C5W CS3 DU5 EBS EFJIC EJD F5P FDB FEDTE FGOYB GBLVA HVGLF HZ~ IHE J1W J5H K-O KOM L7B M41 MO0 N9A NQ- O9- OK1 OQ. P2P PH~ R2- RIG ROL RPZ SDP SEL SES SEW SSZ UNMZH UV1 VH1 W2D X7M XH2 XJT XPP YOC YZZ Z5R ZA5 ZGI ZXP ~S- 08R AAPBV AAUGY ABPTK IQODW 0SF ADVLN AFCTW AFJKZ AKRWK CGR CUY CVF ECM EIF NPM AAYXX CITATION 7X8 |
ID | FETCH-LOGICAL-c502t-648c4c8ec3138b3515e6e9b47e84e18094c43bfdccfa489208935268fa8de2203 |
ISSN | 0015-0282 |
IngestDate | Sat Aug 17 02:00:16 EDT 2024 Thu Sep 26 16:44:45 EDT 2024 Sat Sep 28 08:39:15 EDT 2024 Sun Oct 22 16:04:17 EDT 2023 Fri Feb 23 02:31:13 EST 2024 |
IsDoiOpenAccess | false |
IsOpenAccess | true |
IsPeerReviewed | true |
IsScholarly | true |
Issue | 1 |
Keywords | preterm birth twins Multifetal reduction growth restriction Human Pregnancy disorders Multiple pregnancy Multifetal pregnancy reduction Risk factor Assisted procreation Premature delivery Complication Twin pregnancy Comparative study Multiple birth |
Language | English |
License | CC BY 4.0 |
LinkModel | OpenURL |
MergedId | FETCHMERGED-LOGICAL-c502t-648c4c8ec3138b3515e6e9b47e84e18094c43bfdccfa489208935268fa8de2203 |
Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
OpenAccessLink | https://doi.org/10.1016/s0015-0282(97)81851-1 |
PMID | 8986679 |
PQID | 78793138 |
PQPubID | 23479 |
PageCount | 4 |
ParticipantIDs | proquest_miscellaneous_78793138 crossref_primary_10_1016_S0015_0282_97_81851_1 pubmed_primary_8986679 pascalfrancis_primary_2523248 elsevier_sciencedirect_doi_10_1016_S0015_0282_97_81851_1 |
PublicationCentury | 1900 |
PublicationDate | 1997 1997-Jan 1997-01-00 19970101 |
PublicationDateYYYYMMDD | 1997-01-01 |
PublicationDate_xml | – year: 1997 text: 1997 |
PublicationDecade | 1990 |
PublicationPlace | New York, NY |
PublicationPlace_xml | – name: New York, NY – name: United States |
PublicationTitle | Fertility and sterility |
PublicationTitleAlternate | Fertil Steril |
PublicationYear | 1997 |
Publisher | Elsevier Inc Elsevier Science |
Publisher_xml | – name: Elsevier Inc – name: Elsevier Science |
References | Timor-Tritsch, Peisner, Monteagudo, Lerner, Sharma (bib3) 1993; 168 Melgar, Rosenfeld, Rawlinson, Greenberg (bib5) 1991; 78 Berkowitz, Lynch, Lapinski, Bergh (bib1) 1993; 169 National Center for Health Statistics (bib8) 1988 Evans, Dommergues, Wapner, Lynch, Dumez, Goldberg (bib9) 1993; 82 Wapner, Savis, Johnson, Weinblatt, Fischer, Jackson (bib2) 1990; 335 Evans, Dommergues, Wapner, Goldberg, Lynch, Zador (bib4) 1996; 3 Blumenfeld, Dirnfeld, Abramovici, Amit, Bronshtein, Brandes (bib7) 1992; 99 Alexander, Hammond, Steinkampf (bib6) 1995; 64 9207608 - Fertil Steril. 1997 Jul;68(1):177-8 Melgar (10.1016/S0015-0282(97)81851-1_bib5) 1991; 78 Evans (10.1016/S0015-0282(97)81851-1_bib9) 1993; 82 Evans (10.1016/S0015-0282(97)81851-1_bib4) 1996; 3 Timor-Tritsch (10.1016/S0015-0282(97)81851-1_bib3) 1993; 168 Alexander (10.1016/S0015-0282(97)81851-1_bib6) 1995; 64 Wapner (10.1016/S0015-0282(97)81851-1_bib2) 1990; 335 Blumenfeld (10.1016/S0015-0282(97)81851-1_bib7) 1992; 99 National Center for Health Statistics (10.1016/S0015-0282(97)81851-1_bib8) 1988 Berkowitz (10.1016/S0015-0282(97)81851-1_bib1) 1993; 169 |
References_xml | – volume: 64 start-page: 1201 year: 1995 end-page: 1203 ident: bib6 article-title: Multifetal reduction of high-order multiple pregnancy: comparison of obstetrical outcome with nonreduced twin gestations publication-title: Fertil Steril contributor: fullname: Steinkampf – volume: 169 start-page: 17 year: 1993 end-page: 21 ident: bib1 article-title: First-trimester transabdominal multifetal pregnancy reduction: a report of two hundred completed cases publication-title: Am J Obstet Gynecol contributor: fullname: Bergh – volume: 78 start-page: 763 year: 1991 end-page: 767 ident: bib5 article-title: Perinatal outcome after multifetal reduction to twins compared with nonreduced multiple gestations publication-title: Obstet Gynecol contributor: fullname: Greenberg – volume: 168 start-page: 799 year: 1993 end-page: 804 ident: bib3 article-title: Multifetal pregnancy reduction by transvaginal puncture: evaluation of the technique used in 134 cases publication-title: Am J Obstet Gynecol contributor: fullname: Sharma – volume: 335 start-page: 90 year: 1990 end-page: 93 ident: bib2 article-title: Selective reduction of multifetal pregnancies publication-title: Lancet contributor: fullname: Jackson – volume: 82 start-page: 61 year: 1993 end-page: 66 ident: bib9 article-title: Efficacy of transabdominal multifetal pregnancy reduction: collaborative experience among the world's largest centers publication-title: Obstet Gynecol contributor: fullname: Goldberg – year: 1988 ident: bib8 article-title: Detail Natality 1988; Public use data tape contributor: fullname: National Center for Health Statistics – volume: 3 start-page: 23 year: 1996 end-page: 26 ident: bib4 article-title: International, collaborative experience of 1789 patients having multifetal pregnancy reduction: a plateauing of risks and outcomes publication-title: J Soc Gynecol Invest contributor: fullname: Zador – volume: 99 start-page: 333 year: 1992 end-page: 337 ident: bib7 article-title: Spontaneous fetal reduction in multiple gestations assessed by transvaginal ultrasound publication-title: Br J Obstet Gynecol contributor: fullname: Brandes – volume: 64 start-page: 1201 year: 1995 ident: 10.1016/S0015-0282(97)81851-1_bib6 article-title: Multifetal reduction of high-order multiple pregnancy: comparison of obstetrical outcome with nonreduced twin gestations publication-title: Fertil Steril doi: 10.1016/S0015-0282(16)57985-0 contributor: fullname: Alexander – year: 1988 ident: 10.1016/S0015-0282(97)81851-1_bib8 contributor: fullname: National Center for Health Statistics – volume: 99 start-page: 333 year: 1992 ident: 10.1016/S0015-0282(97)81851-1_bib7 article-title: Spontaneous fetal reduction in multiple gestations assessed by transvaginal ultrasound publication-title: Br J Obstet Gynecol doi: 10.1111/j.1471-0528.1992.tb13734.x contributor: fullname: Blumenfeld – volume: 78 start-page: 763 year: 1991 ident: 10.1016/S0015-0282(97)81851-1_bib5 article-title: Perinatal outcome after multifetal reduction to twins compared with nonreduced multiple gestations publication-title: Obstet Gynecol contributor: fullname: Melgar – volume: 169 start-page: 17 year: 1993 ident: 10.1016/S0015-0282(97)81851-1_bib1 article-title: First-trimester transabdominal multifetal pregnancy reduction: a report of two hundred completed cases publication-title: Am J Obstet Gynecol doi: 10.1016/0002-9378(93)90124-2 contributor: fullname: Berkowitz – volume: 168 start-page: 799 year: 1993 ident: 10.1016/S0015-0282(97)81851-1_bib3 article-title: Multifetal pregnancy reduction by transvaginal puncture: evaluation of the technique used in 134 cases publication-title: Am J Obstet Gynecol doi: 10.1016/S0002-9378(12)90823-6 contributor: fullname: Timor-Tritsch – volume: 82 start-page: 61 year: 1993 ident: 10.1016/S0015-0282(97)81851-1_bib9 article-title: Efficacy of transabdominal multifetal pregnancy reduction: collaborative experience among the world's largest centers publication-title: Obstet Gynecol contributor: fullname: Evans – volume: 335 start-page: 90 year: 1990 ident: 10.1016/S0015-0282(97)81851-1_bib2 article-title: Selective reduction of multifetal pregnancies publication-title: Lancet doi: 10.1016/0140-6736(90)90550-O contributor: fullname: Wapner – volume: 3 start-page: 23 year: 1996 ident: 10.1016/S0015-0282(97)81851-1_bib4 article-title: International, collaborative experience of 1789 patients having multifetal pregnancy reduction: a plateauing of risks and outcomes publication-title: J Soc Gynecol Invest doi: 10.1016/1071-5576(95)00037-2 contributor: fullname: Evans |
SSID | ssj0006172 |
Score | 1.7753373 |
Snippet | To compare pregnancy outcome in twin gestations resulting from multifetal reduction to “primary” twin pregnancies derived from either spontaneous conception or... To compare pregnancy outcome in twin gestations resulting from multifetal reduction to "primary" twin pregnancies derived from either spontaneous conception or... OBJECTIVETo compare pregnancy outcome in twin gestations resulting from multifetal reduction to "primary" twin pregnancies derived from either spontaneous... |
SourceID | proquest crossref pubmed pascalfrancis elsevier |
SourceType | Aggregation Database Index Database Publisher |
StartPage | 30 |
SubjectTerms | Adult Biological and medical sciences Birth Weight Case-Control Studies Diseases of mother, fetus and pregnancy Female Fetal Growth Retardation - etiology growth restriction Gynecology. Andrology. Obstetrics Humans Infant, Newborn Medical sciences Multifetal reduction Obstetric Labor, Premature - etiology Pregnancy Pregnancy Reduction, Multifetal - adverse effects Pregnancy. Fetus. Placenta preterm birth Twins |
Title | Multifetal reduction increases the risk of preterm delivery and fetal growth restriction in twins: A case-control study |
URI | https://dx.doi.org/10.1016/S0015-0282(97)81851-1 https://www.ncbi.nlm.nih.gov/pubmed/8986679 https://search.proquest.com/docview/78793138 |
Volume | 67 |
hasFullText | 1 |
inHoldings | 1 |
isFullTextHit | |
isPrint | |
link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1bb9MwFLbKJiEkHrhsosDADzyAqoRc3MTmrYKWjnUVajfYW5SLDZNQO62tQPwr_iHnxI6d3TTBS9RGsi3lfDnn88l3jgl5paJYsbxingxZ4bFcFR6vVOlBJEoSkedBwbBQ-HCajI_Zp5P-Safzp6Va2qwLv_x9bV3J_1gV7oFdsUr2HyxrJ4Ub8BvsC1ewMFyv2vjaUDNCWXTNpOsEODZexn9tINQltkrqDv6VbhbbO10gW1xhfweUGBp9OYoPwVP3KvkD5Rp6Uj30G2zX1997eJLH-WlpFZI_UWGjq9tLmM5rlO-uay1mb_YnX4zgwndp1fFwMhpMP9QA851We3Y8nw8nkxpHfs-mpmeDj_tTl3utTOFeeilPYQtojM9qO-UQi8T1GUS-NH64n3jANeO2o9bndlwApPa65suOjt-6r8aVyKCTFHO7GPB37EEskLCEXujCYSMBuBQlrXYx6iMJ5XfIdhSLPjjS7cHB7OuBDf9ICXX41wu5srG3bvXXIn1jVr6JEN0_y1fwmip9vsrNG6CaCB09IDuuRJR-toh8SDpy8YjcPTRKjcfkl4MdtbCjFnYUYEcRdnSpqIEdbWBHAXZUD9Wwoy3YwRy0hh19Rwe0DTpag26HHI-GR-_Hnjnlwyv7QbT2EsZLVnJZxmHMixj4tUykKFgqOZPYXY6VLC5UVZYqZ1xEATBs7FGkcl7JKAriXbK1WC7kE0LDBHAXBnlQMSDGeKoMS1RaCdhTY01b0SV-86izM93MJXMqR7BNhrbJRJrVtsnCLuGNQTLDSDXTzABWtw3du2BAu6DBT5e8bAyagUfHz3T5Qi43qwxCqMBn0SW72s52KBc8SVLx9Japn5F77gV8TrbW5xu5B9R5XbwwYP0LNN7Aig |
link.rule.ids | 310,311,315,786,790,795,796,4043,4069,4070,23958,23959,25170,27954,27955,27956 |
linkProvider | Library Specific Holdings |
openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=proceeding&rft.title=Fertility+and+sterility&rft.atitle=Multifetal+reduction+increases+the+risk+of+preterm+delivery+and+fetal+growth+restriction+in+twins+%3A+A+case-control+study&rft.au=SILVER%2C+R.+K&rft.au=HELFAND%2C+B.+T&rft.au=RUSSELL%2C+T.+L&rft.au=RAGIN%2C+A&rft.date=1997-01-01&rft.pub=Elsevier+Science&rft.issn=0015-0282&rft.eissn=1556-5653&rft.volume=67&rft.issue=1&rft.spage=30&rft.epage=33&rft_id=info:doi/10.1016%2FS0015-0282%2897%2981851-1&rft.externalDBID=n%2Fa&rft.externalDocID=2523248 |
thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0015-0282&client=summon |
thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0015-0282&client=summon |
thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0015-0282&client=summon |