What is Fetal Reduction?
Fetal Reduction is a procedure used to reduce the number of fetuses in multiple pregnancies, usually more than two.
When pregnancy involves three or more fetuses, the risks of miscarriage, stillbirth, and structural malformation increase with each additional fetus.
Fetal Reduction refers to choosing to reduce a fetus in multiple pregnancies, decrease the health risks to the mother in carrying and giving birth to more than one or two babies, and decrease the risk of complications to the remaining fetuses.
The chance of multiple pregnancies increases in the case of artificial reproductive techniques. An IVF aims to achieve and sustain a safe pregnancy that results in a healthy baby.
Fetal Reduction Procedure at Jammi Scans
Fetal Reduction
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How is the Fetal Reduction Procedure Done?
- The most common fetal reduction method is transabdominal (through the abdomen). For this procedure, the doctor uses ultrasound as a guide and inserts a needle through the mother’s abdomen and into the uterus to the selected fetus. The doctor injects the fetus with a potassium chloride/ lignocaine solution, which stops the fetal heart.
- Because it is very small during the first trimester, the reduced fetus is usually absorbed by the mother’s body. This may include some vaginal bleeding.
The goal of Fetal Reduction to increase the chance of a successful, healthy pregnancy.
- Is usually done early in a pregnancy, between 11 to 14 weeks.
- Is most often done when there are three or more fetuses present.
- Can be used to reduce triplets to twins.
- Is known as "selective termination" when it involves a fetus with severe defects or one which would threaten the life of the surviving fetus or fetuses.
Why is the Fetal Reduction Procedure done?
As the number of fetuses increases, the risks of preterm delivery also increase: the average length of pregnancy is known to reduce as the number of fetuses increases.
For example, it is 40 weeks for a singleton, whereas, for twins, it is 36 weeks. This reduces dramatically to 32 to 33 weeks for triplets and 28 to 29 weeks for quadruplets.
When is the Fetal Reduction Procedure Typically Done?
It is usually done between 11 to 14 weeks of pregnancy. It could be done in combination with the first-trimester screening. The procedure usually does not have any adverse effect on the surviving fetus.
How is the fetus selected?
While performing the routine screening ultrasound at 12 to 13 weeks, the fetus which displays signs of an abnormality is selected for Reduction.
If all the fetuses appear normal during the ultrasound scan, then the easily approachable fetus is targeted for Reduction. It must be noted that fetuses are not selected based on gender.
This is strictly prohibited under PCPNDT law, and the sex of the fetuses are not revealed and is also not studied.
What are the risks involved in Fetal Reduction?
- In higher-order multiple pregnancies (three or more), malformation or intra-uterine death risks are higher with each additional fetus.
- While fetal Reduction increases the chances of healthy survival for the remaining fetuses, it may sometimes lead to miscarriage of the remaining fetuses, preterm labor or infection.
- About 75% of women who undergo fetal Reduction will go into premature labor. About 4-5% of women undergoing fetal Reduction also miscarry one or more of the remaining fetuses. Other side effects include fever, vaginal bleeding, leaking or contractions.
Frequently Asked Questions
1. What happens next to a multifetal reduction procedure?
The pregnancy will be closely monitored to observe if there are any complications following the procedure.
2. What happens to the fetal material after reduction?
Usually, the fetal material is reabsorbed by the mother’s body.
3. Does fetus reduction cause bleeding?
Fetal reduction may sometimes include vaginal bleeding or leaking.
4. Is fetal reduction legal?
The legality of fetal reduction is limited to cases where there is no violation of the law (i.e. fetal reduction for pure gender-based and financial reasons is not allowed). Chennai Women’s Clinic allows this procedure only if there is a medical threat or risk to the mother’s health or other fetuses.
5. Is fetus reduction painful?
This procedure does not cause much physical pain. However, you will be given local anesthesia before the process starts.