Selective Multifetal Reduction

The procedure used to reduce the number of fetuses in a multiple pregnancy is called ‘selective multifetal reduction’. A pregnancy may involve three or more fetuses. It is known as ‘high-order’ pregnancy. With each additional fetus, the chance for miscarriage, lifelong disability and stillbirth also increases. There has a great number of increase in multiple pregnancies caused due to Assisted Reproductive Technology and use of fertility drugs. In such cases, healthy and successful pregnancies can be achieved with selective multifetal reduction procedure.

The procedure of multifetal reduction is usually done through the vagina(transvaginal). In this procedure, the doctor will use ultrasound as a guide. A needle will be inserted through the woman’s vagina under ultrasound guidance, then into the uterus and to the selected fetus. An injection with potassium chloride will be instilled to the fetus. This is done in order to stop the fetal heart. As a result, the fetus will die inside the abdomen. The fetus will be very small during the first trimester period of pregnancy; when the selective multifetal reduction is done. The dead fetus need not to be removed as it will be absorbed by the mother’s body. There can be some vaginal bleeding after completing the procedure.

Three or more fetuses in the uterus are highly risky and it should be removed. But sometimes, selective multifetal reduction can lead to issues such as miscarriage of remaining fetus, infection or preterm labour. This may happen only in a very few cases. It is important to think and plan well before going for the multifetal pregnancy reduction procedure. Our doctor can help you in making you understand the risks and possibilities of the procedure.