When to Consider Multifetal Pregnancy Reduction?

Certain risks come with carrying multiple fetuses during pregnancy. One efficient way to minimise these risks is by undergoing a multifetal pregnancy reduction procedure. Here’s what to know about this choice and how it can help.

Being a parent is a joyful experience, and the news of having multifetal pregnancies, such as twins, triplets, or higher multiples, can bring happiness and excitement to expectant parents. However, it is not uncommon for pregnancies with multiple fetuses to present challenges and potential risks for both the mother as well as the babies. In these situations, multifetal pregnancy reduction (MFPR) may be considered an option.

In this blog, we will look at when it would be important to think about MFPR and the considerations that go into this choice.

What is Multifetal Pregnancy?

When a woman conceives more than one fetus at once, it is known as a multifetal pregnancy. If you are carrying two babies, they are called twins. When three babies are carried during one pregnancy, they are called triplets. You can also carry more than three babies at one time (high-order multiples).

There are typically more complications linked to a multiple pregnancy than a singleton (carrying only one baby) pregnancy. These can include preterm birth, low birth weight, gestational diabetes, preeclampsia, and developmental issues. The emotional, physical, and financial strain on the parents can also be substantial.

Understanding Multifetal Pregnancy Reduction

Multifetal pregnancy reduction, also known as selective reduction, is a surgical procedure performed during the first trimester of a multifetal pregnancy. This procedure aims to reduce the number of fetuses to increase the chances of a healthy outcome for both the remaining fetuses and the mother. If a pregnancy involves more than two fetuses, MFPR may be recommended to minimize the risks associated with carrying multiple pregnancies and improve the chances of a healthy pregnancy.

How It’s Done:

Multifetal pregnancy reduction is typically performed around 12 to 13 weeks of gestation, using ultrasound guidance. In some unusual cases, MFPR can be done even in the second or third trimester as well. The specifics of the procedure may vary depending on the number of fetuses being reduced. Before the procedure, a detailed anatomical evaluation with an NT scan is done for all the fetuses to make sure there are no significant structural abnormalities in the fetuses.

A needle is guided into the uterus during the procedure under ultrasound visualization. A medication may be injected into the targeted fetuses to stop their heartbeat. The body absorbs the reduced fetus(es) over time, and the remaining fetuses continue to develop. In some cases, a technique called radiofrequency ablation may be used instead. In this, a small needle device cuts off the blood flow from the umbilical cord to one or more fetuses.

After the procedure, your doctor will do another ultrasound to check on the rest of your babies.

(Also Read: Fetal Echocardiography and Diagnosis of Heart Abnormalities (preciousfetalmedicine.com))

When to Consider Multifetal Pregnancy Reduction

Considering multifetal pregnancy reduction is a personal choice, made after extensive consultation with fetal medicine experts. Here are some situations in which it might be considered:

  • High-risk pregnancies: Multiple pregnancies, in general, entail higher risks for both the mother and the fetus. MFPR may be a possibility if a mother’s health is in danger due to complications such as gestational diabetes, preeclampsia, or preterm delivery.
  • Fetal health concerns: If defects or developmental problems are found in one or more fetuses during prenatal screenings or sonography scans, selective reduction of the fetuses may be advised. This allows the remaining fetuses to have a better chance of healthy development.
  • Gestational complications: In some cases, multifetal pregnancies can lead to risks like premature rupture of membranes, intrauterine growth restriction, and placental abnormalities. Multifetal pregnancy reduction may be considered as a way to reduce these risks and raise your chances of having a healthy baby and a successful pregnancy.
  • Personal considerations: Every family is different, as are the circumstances of each individual. Factors such as financial limitations, emotional preparedness, and the ability to provide proper care to multiple children are all essential considerations when deciding whether to consider multifetal pregnancy reduction.

A Final Note

Multifetal pregnancy reduction is a complex and deeply personal decision that should be made considering various factors, including maternal health, fetal well-being, and individual circumstances. It’s crucial to understand that the decision to undergo this procedure should be made after thorough discussion and understanding of the associated benefits and risks, as well as in consultation with a qualified healthcare provider specializing in fetal medicine. Ultimately, the goal is to achieve the best possible outcome for the mother and the remaining fetuses, ensuring a safe and healthy pregnancy.

Get Multifetal Pregnancy Reduction in Pune

Consult fetal medicine specialist Dr Tejas Tamhane to help manage complex fetal conditions.

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