Selective Reduction

Definition - What does Selective Reduction mean?

Selective reduction is a process that aborts one or more fetuses in the case of a high order multiple (3 or more) pregnancy. Multifetal pregnancies of 3 or more are considered high risk, as the chance of negative outcomes for mother and fetuses, including birth defects, disabilities, miscarriage, and stillbirth is high. Assisted reproductive technology and fertility drugs significantly raise the chances of becoming pregnant with high-order multiples.

Selective reduction is also called multifetal pregnancy reduction.

FertilitySmarts explains Selective Reduction

The purpose of selective reduction is to raise the likelihood of a healthy and successful pregnancy. The procedure is typically completed on pregnancies with four or more fetuses, although it may be recommended for some sets of triplets. When a fetus with defects or abnormalities is selected for reduction, it is considered a “selective termination.”

The procedure is performed between the 9th and 12th weeks of pregnancy, through a transabdominal method. Using an ultrasound machine, a physician guides a needle into a woman’s abdomen, injecting the selected fetus with a solution of potassium chloride. The solution causes the fetal heartbeat to stop. The early age of the pregnancy results in the mother absorbing the fetal content. Typically, the other fetuses are not disturbed during this process. Overall, selective reduction is considered the most effective way to increase the chance of a healthy and successful pregnancy for the remaining fetuses. However, the procedure does increase the chance of certain risks, including:

  • Infection
  • Preterm labor
  • Miscarriage of remaining fetus or fetuses

Selective reduction has both an ethical and emotional component. It remains a controversial topic for the medical community and may have a significant impact on patients who undergo the process. Women or couples facing selective reduction should seek resources, emotional support and spiritual guidance as needed.

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