Abstract: Multifetal reduction is the termination of one or more fetuses in a multifetal pregnancy to decrease the likelihood of maternal and fetal morbidity and mortality. Before the procedure, an ultrasound exam should be performed to assess the fetal number and chorionicity and to screen for fetal anatomic abnormalities. Genetic screening/testing should also be offered as the findings may lead to the selective termination of an anomalous fetus. Fetal reduction is achieved through intracardiac instillation of potassium chloride or, in the case of monochorionic fetuses, radiofrequency cord ablation. This procedure should be performed under ultrasound guidance and is mostly commonly performed through a transabdominal approach. Fetal and neonatal outcomes are dependent on the starting and finishing fetal numbers. Triplet pregnancies reduced to twins have lower total pregnancy loss rates, preterm delivery <28 weeks, NICU admission, and perinatal mortality. Although there appears to be a benefit to reducing higher-order multiples to a twin gestation, the benefit of reducing a twin pregnancy to a singleton less clear. The maternal benefits of fetal reduction include decreased rates of hypertensive diseases of pregnancy, gestational diabetes, and cesarean delivery.
Publication Year: 2017
Publication Date: 2017-11-29
Language: en
Type: book-chapter
Indexed In: ['crossref']
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Cited By Count: 1
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