Multi-fetal Pregnancy Reduction

Triplet pregnancy and higher-order pregnancies carry a high-risk of premature births, miscarriages, stillbirths and neonatal deaths. Medical or surgical interventions have not shown to be of much help in reducing the above-mentioned problems. The current standard treatment to improve the outcome of such pregnancies is to ‘reduce’ the pregnancy to a twin pregnancy. However, reduction may not be acceptable to some parents. At FETOSCAN, a detailed sensitive and scientifically accurate counselling is first given and the parents values and preferences are taken into account. Accordingly, a management plan is charted out. When the fetuses have their own placenta each, then this reduction is done at 12 weeks using a simple technique; when the fetuses share a single placenta, then reduction is performed at 16 weeks using radiofrequency ablation technique (RFA). The procedure related loss rate after fetal reduction is about 2% when done in the first trimester and is about 10% when done in the second trimester (RFA). Typically, the patient preparation, duration, and post procedure precautions are the same as that of amnio / CVS.