What is Fetal Reduction?

Fetal reduction is the procedure of reducing the number of babies in a multiple pregnancy, say quintuplets (5 babies), quadruplets (4 babies) or triplets (3 babies) to twins or singleton pregnancy especially so when one or more babies have a structural or chromosomal abnormality.

Who should get it done?

Fetal reduction is used when a mother carries an unsafe or undesirable number of fetuses in a multiple pregnancy and reduce it to a relatively safe or desirable number.

When is it done?

It is usually done after NT/NB scan. This helps in evaluating the babies and deciding the method and timing of procedure. However it can be done later in pregnancy if any major abnormality is diagnosed in the baby.

How is the procedure done?

You would have to come with your husband/relative for the procedure. Prior to the procedure, you would be explained the procedure with its benefits and risk. You would be asked to sign a written consent.

You may be asked to empty your bladder before the procedure. Like an ultrasound examination, you would be asked to lie down on a couch. Your tummy would be cleaned by antiseptic. A local anaesthetic injection may be used to numb a small area.

Under antibiotic cover a thin needle is inserted through the abdomen (belly) and into the uterus guided by ultrasound and a medicine (potassium chloride) is injected into into one of the babies to stop its heart beat.

After the needle is removed, remaining baby/babies are checked. You would usually be advised admission for a day for monitoring. Baby’s heart will again be checked the next day before going home.

What are the benefits of the procedure?

Fetal reduction substantially increases the duration of pregnancy, reduces the risk of premature births associated with multiple pregnancy. It allows parents to get desired number of babies if they want.

Are there any risks?

It is generally a safe procedure. Some may consider the procedure to be uncomfortable or slightly painful. Some say it feels something like period pain. You may feel anxious before and after the test. You may notice some cramping for a few hours afterwards.

Depending on how many babies are reduced, there is a 5-15% chance of miscarriage. Other risks include bleeding, leaking, infection etc.

Note:

If your blood group is Rh (rhesus) negative, it will be recommended that you have an injection of anti-D immunoglobulin before the procedure to prevent you from developing antibodies against your baby’s blood cells.

If you have HIV, hepatitis B or hepatitis C viruses, CVS might increase the risk that you pass this on to your baby. You are expected to get screened for these viruses before the procedure. If you screen positive for any of these, your options and further care would be discussed.