Fetal reduction and selective termination

Over the course of the past several years, multifetal pregnaney reduction (MFPR) has emergeel as a method to redııee the high perinatal morbidity anel mortality secondary to iatrogenic multifeta! pregnancies created by excessiye hormonal stimulation and aggressive assisted reproductive teehnologies. The experience of a limited number of groups worldwiele shows that MFPR is performed mostly as a transabdominal neeelle insertion into the fetal thorax of potas,ium chloride. The technleal success rate of the proceelure approaches 100 %, and in experieneed hands, the takehome baby rate is comparable to that of the background expeetations for the stopping number of fetuses. In a series of over 1000 cases, most all of which were reduced from higher order of numbers to twins, the percentage of pregnancies reaching viability for 3 to 2 has been 95 %,4 to 2 90 %, and 5+ to 2 80 %. There are also higher risks for prematuritiy with greater starting and stopping numbers. For second trimester proeedures done for fetal abnormalities, referred to as seleetive termination, there is an inverse correlation between the gestational age at the proeedure and the likelihood of feta! lass, with 10SS l'ates prior to 16 weeks approximately 5 %, and greater than 17 weeks approximately 15 %. There have been no instances of coagulopathies nor damaged suryiyOfs in dizygotie gestations.

Anahtar Kelimeler

-