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Multifetal pregnancy reduction (MFPR)

MFPR is the procedure of reducing multiple pregnancies to twins or singleton. 29 year old conceived by means of IVF presented with triplet pregnancy at 12 weeks 4 days. It was trichorionic triamniotic- 3 babies with their own sacs and placentas. A detailed evaluation of all three twins was done. The evaluation was normal for the gestation After discussing the pros and cons, the couple decided to go ahead with reduction to twins. Twin 3 which was far away from the os was selected for reduction. By means 22G needle, triplets were reduced to twins.

Trisomy 21

38 year old Gravida 5 Para 1 with previous one normal child and 3 miscarriages was referred with increased risk of Trisomy 21 (1:50) on quadruple screening test. There was no first trimester screening for aneuploidy. Her anomaly scan done outside was also normal. We discussed the options of invasive testing and non-invasive prenatal screening test (NIPS). After counselling, the couple decided to go ahead with NIPS. Before NIPS, as a protocol, we do an ultrasound to assess the fetus. On our assessment, there was presence of intra-cardiac echogenic foci, hypoplastic nasal bone and flat facial profile. Hence, it was discussed with the couple and amniocentesis for FISH and Karyotype was performed. The FISH karyotype report was Trisomy 21. That’s how a proper scanning can change the management and help us to detect abnormalities in time.