How Safe is Foetal (Selective) Reduction?

Most people opt for fertility treatments when they are struggling to get pregnant. But where they are expecting one baby, cases arise when a pregnancy might include twins, triplets, or even more babies. Carrying them ahead healthily may not always be possible, and undergoing a pregnancy reduction might be a decision you would have to make.

What Is Multifetal Reduction?

A multifetal reduction is a surgical procedure. It is used to reduce the number of foetuses held by a pregnant woman so that the resultant number of foetuses can be carried forward and successfully delivered. It is also termed as selective pregnancy reduction in some cases.

Why Is a Foetal Reduction Done?

If getting pregnant is a difficult task in itself, keeping that pregnancy healthy and having an uncomplicated delivery is even more difficult. These become tough with every foetus that grows within the uterus. Risks of babies being stillborn or having a miscarriage increase rapidly when pregnant with multiples. Some babies may not develop correctly or have birth-related defects. Therefore, a foetal reduction helps keep these risks to a minimum level.

Benefits of Multifoetal Pregnancy Reduction

There is a strong reason why mothers carrying multiple foetuses think about undergoing a multifetal pregnancy reduction. The benefits that stem as a result of it are not just beneficial for the other children growing in the mother’s womb, but is also a good way to ensure a great future for the ones that continue ahead in life.

1. Reduced Child Cost

The expenses incurred in taking care of multiple children is not something that is affordable for every family. With all children being at the same age, they can quickly shake your financial stability. MFPR can help you keep the costs in a range that works for you.

2. Reduced Mental Stress

While financial problems might be one variable of the equation, taking care of multiple children right after birth is a task difficult. It can quickly get overwhelming for first-time mothers. Sticking to no more than a couple of babies can help you keep your own mental health and physical health in optimal condition to care for the children.

3. Reduced Pregnancy Problems

Every additional foetus that grows within your body does not only increase the size of your uterus and tummy, but also stresses your body further in a bid to share resources. Each child taps into the body for resources and has a significant impact on other areas as well. These further increase chances of anaemia, preeclampsia, or diabetes to set in during pregnancy.

4. Reduced Pregnancy Risks

While most mothers can deal with pregnancy problems through the journey until delivery, most of the significant risks usually emerge at that point itself. The chances of undergoing a premature delivery, a miscarriage, or development of congenital disabilities are extremely high when a woman is pregnant with multiple foetuses.

Risks Associated With MFPR

While multifetal pregnancy reduction has numerous benefits that are good for the mother and the children that will be given birth to, it is not free from foetal reduction risks that might manifest as a result of the procedure itself.

1. Emotional Toll

Some parents develop a strong connection with their foetuses pretty early in the pregnancy. Seeing them in ultrasounds and naming them right away can create a strong bond of parenthood with them. Therefore, undergoing an MFPR can cause a feeling of guilt or sadness of having rejected their own children. Extreme cases can cause depression to manifest within the mother too, which isn’t good for the remaining babies.

2. The Possibility of an Infection

The MFPR procedure requires external items to come in contact with the tummy or the uterus, in order to reduce the number of foetuses in the uterus successfully. As minor as it might be, there is a minuscule probability of an external infection finding its way inside. The incidents are relatively rare, but if an infection does take place, then it can put the remaining foetuses at risk.

3. A Miscarriage of the Complete Pregnancy

Any disturbance to the existing condition of the foetus always opens up the risk factor of miscarriage. In most cases, if the number of the foetus are few, generally around 3 or 4, the chances of miscarriage are minimal, usually around 4% or so. However, as the number of existing foetuses starts increasing, reaching 6 or more, the risks associated with miscarriage are quite high. Therefore, a decision of proceeding ahead with MFPR might need to be taken carefully.

Precautions to Take Before Multifetal Reduction Process

A pregnancy that consists of multiple foetuses usually occurs after undergoing fertility treatment, involving drugs that put the body in the optimum state for pregnancy. Having made this effort, it might be difficult for you to come to terms with reducing the number of foetuses, as well as opening up to the risk of a miscarriage of the remaining ones as well. While most fertility clinics do provide this information beforehand, understanding the repercussions of this decision is extremely necessary.

Foetal Reduction Procedure

When opting for a multifetal pregnancy reduction procedure, the timing needs to be right as well. The apt time for carrying out the procedure is within the first trimester. The foetuses are at the initial stage of their growth around this time and are usually located within separated pouches filled with amniotic fluid. They are yet to share the uterus together.

Doctors may make use of a probe to carry out an ultrasound. This technique helps to get a detailed understanding of the foetuses within the uterus, as compared to the normal ultrasound. The probe helps provide the correct positioning of the foetuses within the uterus. Using that as a map, a medical process is initiated to reduce the individual foetuses gently. This makes use of a medicine that is intended to stop the heartbeat of that particular foetus. The correct foetus is determined, with the help of a needle that is inserted through the stomach or the vagina, and the medicine is injected into the foetus’s pouch.

Another alternative is to remove the blood flow received by the foetus from the umbilical cord. Here, your doctor might use the radiofrequency ablation technique, that makes use of electric currents, instead of medicine via the needle.

The number of foetuses to be reduced in a single session, but it depends on your health, the total number of foetuses, and the doctor’s recommendation. Your doctor might give you general anaesthesia throughout the procedure to keep you away from the process, even though it might be over in a few minutes. However, general anaesthesia poses its own side effects and is usually not given to pregnant women.

What to Expect After Selective Reduction

Once the procedure is completed, you would be asked to stay in the hospital for about 12-24 hours under observation. The remaining foetuses would be observed via ultrasound regularly. A small counselling session might be conducted to gauge your mental well-being.

FAQs

Here are a few questions that are generally on the mind of many women looking to undergo selective pregnancy reduction.

1. Is Foetal Reduction Procedure Painful?

Some doctors do give general anaesthesia during the procedure, while others may use only local anaesthesia. In either case, the procedure does not cause much physical pain and is completed within a few minutes.

2. How Much Does Selective Reduction Cost?

The expenses for the procedure differ from hospital to hospital, depending on the number of foetuses, and the complexity. At times, your fertility clinics might include the cost in their package as an optional service.

Reducing your existing foetuses is a tricky procedure for the body, but it also affects your emotions. Discuss it with your partner and your doctor before making a decision, and know it is for your best and the benefit of the remaining babies.

Also Read: Multiple Pregnancy – Getting Pregnant with Twins or Triplets