When is Multifetal pregnancy reduction performed?

Multifetal pregnancy reduction is a procedure to reduce the number of fetuses in a pregnancy—usually from three, four, or five fetuses to two. This may help the two fetuses survive and help you have a healthy pregnancy. This procedure is most often done early in a pregnancy, between the 9th and 12th weeks.

How common is Multifetal reduction?

It has since stabilized and is currently 33.5 twins per 1,000 live births 4. The birth rate for higher-order multiples increased more than 400% between 1980 and 1998, when it peaked at 1.935 per 1,000 births 3. Between 1998 and 2015, deliveries of higher-order multiples decreased by 46% to 1.036 per 1,000 births 4.

What is selective reduction in pregnancy?

Selective reduction refers to the procedure of aborting 1 or more fetuses in a multiple pregnancy induced by fertility drugs or in vitro fertilization.

Can you reduce identical twins?

Reduction of monochorionic twins contained in multiple pregnancies appears to be a safe option. Successful reduction of one of the monozygotic twins provides a choice for reproductive medicine workers and patients.

What is the definition of multifetal pregnancy reduction?

Multifetal pregnancy reduction is defined as a first-trimester or early second-trimester procedure for reducing the total number of fetuses in a multifetal pregnancy by one or more 1. In most cases, the involved gestations will be higher-order multifetal pregnancies, defined by the presence of three or more fetuses.

Can a woman miscarry after a multifetal pregnancy reduction procedure?

A small number of women can miscarry after the procedure. And you still might have a chance of going into labor too early. To help the rest of your fetuses survive, your doctor will give you special instructions to follow during your pregnancy. These could include a diet high in calories and protein, medication, or extra bed rest.

How does reducing the number of fetuses reduce spontaneous pregnancy loss?

Reducing the pregnancy by one or more fetuses decreases the spontaneous pregnancy loss rates for all multifetal pregnancies, with the most dramatic survival benefits seen with reductions from higher initial starting numbers of fetuses in higher-order multifetal pregnancies 16.

What are the medical risks of multifetal pregnancy?

Maternal risks of multifetal pregnancies include hypertension, preeclampsia, gestational diabetes, and postpartum hemorrhage 17. Patients should be counseled that reduction to a lower-order pregnancy (triplet to twin or twin to singleton) reduces the risk of medical complications associated with maintaining a higher-order multiple pregnancy.