Multifetal pregnancy reduction (MFPR) is a procedure used to reduce the number of fetuses in multiple pregnancy usually to two. Pregnancy involving more than 3 or more fetuses increases the risk for pregnancy complications such as

• miscarriage
• stillbirth
• lifelong disability

Assisted reproductive technology (ART) and fertility drugs greatly increase the number of multiple pregnancies. The goal of this procedure is to increase the chance  of successful, healthy pregnancy. This procedure

• is usually done around pregnancy week 9 to 12
• is usually done when there are 4 or more fetuses present
• can be used to reduce triplets to twins
• is known as selective termination when it involves fetus with severe defects  or one that is expected to die in later pregnancy, which will threaten the life of the surviving fetuses

How is MFPR done ?

The most common method is transabdominal MFPR. The doctor uses and ultrasound to guide a needle through the woman’s abdomen , into the uterus and into the selected fetus. The doctor injects the fetus with potassium chloride solution which stops the fetal heart.

The dead fetus usually absorbs in the mother’s body because its very small. It may include some vaginal bleeding. The process of absorption of the dead fetus into the mother’s body is similar to vanishing twin syndrome.

Are there any risks ?

A successful MFPR increases the chances of survival of the remaining fetuses. However sometimes this procedure can lead to the miscarriage of the other fetuses, preterm labor or infection.

NOTE

This decision can be very difficult to make. If you are faced with this decision, discuss with your doctor the personal risks from trying to carry multiple fetuses to term compared to the risks of choosing MFPR. You should also talk to your spiritual advisor.