Multifetal pregnancy reduction is a procedure that involves reducing the total number of babies in a multiple pregnancy by one or two.
The cases of multiple pregnancy are increasing around the globe especially because of the advanced maternal age at pregnancy and more and more use of artificial reproductive techniques.
When there are more than one fetuses in your womb, there is a possibility of miscarrying the entire pregnancy or early delivery. Babies who are born too soon have the risk of developing jaundice, infection, injuries to brain, breathing problems, feeding problems and require ICU care.
Mothers are also at increased risk of complications during pregnancy like high blood pressure, high sugars, anaemia, preterm delivery.
These problems are more pronounced especially when there are 3 or more babies.
Hence, your obstetrician will suggest you to consult a fetal medicine specialist to discuss about multifetal pregnancy reduction.
Multifetal pregnancy reduction is also offered in those cases in which one of the babies has a lethal structural abnormality
The procedure is done in the first trimester or early second trimester. It is generally done between 11-12 weeks.
It's usually done per abdomen. First, an ultrasound is done to know the type of multiple pregnancy. We look for structural abnormality in any of the babies in your womb. If the initial screening looks ok, we select the baby that is far away from the mouth of uterus and is easily accessible. With the help of ultrasound, a local anaesthetic is injected into the underlying skin so that you don’t feel any pain. We introduce the needle from the tummy into the selected fetus’s heart. We inject the medicine like KCL into the heart. The heart beat stops. We observe for a little while and then the needle is withdrawn.
Those multiple pregnancies where the placenta is shared, a different procedure called laser or radiofrequency ablation is used. The fetal medicine specialist will discuss with you if this kind of procedure is required.
Usually, it is a safe procedure. However, there is minor risk of miscarrying the entire pregnancy. What we have to consider here is the risk benefit ratio analysis. Carrying a multiple pregnancy, increase the risk of preterm delivery by 60% and that to too early. This procedure reduced the risk by half.
The fetal medicine specialist will discuss in detail with you.
Our one of the best fetal medicine consultants Dr. Neha Gupta specializes in this area. You can consult with her. You can call us and request an appointment.