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Chapter 4 - Multifetal Pregnancy Reduction

Published online by Cambridge University Press:  11 October 2022

By
Simi Gupta Talati  and
Andrei Rebarber
Edited by
Leanne Bricker ,
Julian N. Robinson  and
Baskaran Thilaganathan
Leanne Bricker
Affiliation:
Corniche Hospital, Abu Dhabi
Julian N. Robinson
Affiliation:
Brigham & Women's Hospital, Boston
Baskaran Thilaganathan
Affiliation:
St George's Hospital Medical School, University of London
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Summary

Multifetal pregnancy reduction (MFPR) and selective termination (ST) are two options to reduce the number of fetuses in a multiple gestation pregnancy. In MFPR, the fetus or fetuses chosen for reduction are based on technical considerations and may be chosen electively or to reduce the risk of maternal and fetal complications associated with multiple gestation. In ST, the fetus or fetuses chosen for reduction are based on an anomaly. The procedure itself is determined by chorionicity. Fetuses with separate chorionicity are reduced by administering potassium chloride into the fetal heart or thorax. Fetuses that share a placenta are reduced by umbilical cord occlusion through a number of different techniques. Post-procedure management often involves monitoring for fetal growth restriction and preterm labor. In pregnancies reduced by umbilical cord occlusion, post-procedure monitoring can also be performed to evaluate for neurological damage.

Type
Chapter
Information
Management of Multiple Pregnancies
A Practical Guide
 , pp. 39 - 47
Publisher: Cambridge University Press
Print publication year: 2022

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