What is multifetal pregnancy reduction?
pregnancy reduction (MFPR) is a procedure that reduces the number of fetuses in
a multiple pregnancy-usually from three, four, or five fetuses to two so that
the remaining fetuses have a better chance of survival. The goal of MFPR is to
increase the chance of a successful, healthy pregnancy.
An MFPR is
usually done early in a pregnancy, between the 9th and 12th weeks, sometimes
after having genetic testing for fetal problems. The most common method of
fetal reduction is transabdominal MFPR. For this procedure, the doctor uses
ultrasound as a guide and inserts a needle through the
woman's abdomen and into the uterus to the selected fetus. The doctor injects
the fetus with a potassium chloride solution, which stops the fetal heart from
beating. Sometimes, vaginal bleeding happens after the procedure; this is
embryo or fetus is absorbed by the mother's body. This
absorption process is normal and similar to
vanishing twin syndrome.
What are the benefits of a multifetal pregnancy reduction?
Family life. In interviews done
2 years after their pregnancies, parents who reduced their pregnancies to twins
report less anxiety and depression and more satisfaction with their
parent-child relationships than parents of triplets.4
Mother risk. Multiple pregnancy also
increases the mother's risk of pregnancy complications such as
anemia. These risks increase with each additional
fetus in the uterus.
Infant risk. In a
pregnancy with triplets or more, there is a high risk of
miscarriage, stillbirth, premature birth, and
disability. Only half of families with triplets are not
affected by death or a disabled child. Only about one-third of families with
quadruplets are not affected by death or a
disability.5 To lower these high risks, many doctors
offer multifetal pregnancy reduction (MFPR).
pregnancy reduction improves your chances of avoiding miscarriage, carrying
your pregnancy longer, and delivering one or more healthy babies.2
How does a triplet-reduced-to-twin pregnancy compare with a triplet pregnancy?
|| Births and losses of twins after MFPR
|| Births and losses of triplets (no MFPR)
|Percent of planned babies born, taken home
|Premature birth before 32 weeks
|Premature birth before 28 weeks
|Miscarriage before 24 weeks
|One or more fetal deaths during the pregnancy
27 out of 1,000 live births
92 out of 1,000 live births
What are the risks of multifetal pregnancy reduction?
The risks of multifetal pregnancy reduction include:
Miscarriage of the
remaining fetuses. When reducing a triplet to a twin pregnancy, the miscarriage
rate is about the same as in normal twin pregnancies.3
The miscarriage rate seems to be about the same when reducing from 3, 4, or 5
fetuses, but is higher when reducing from 6 or more.6
Emotional risks for you, especially if
the pregnancy miscarries. Some parents who go on to have a healthy pregnancy
view the pregnancy reduction as sad but medically needed. Others who have had
an MFPR followed by a healthy pregnancy first report feeling grief, guilt, and
depression about their decision, though this typically lessens with
Infection of the abdomen or uterus
Some couples choose to implant fewer embryos to reduce
the chances of a pregnancy of triplets or more, rather than consider multifetal
If you need more information, see the topics
Multiple Pregnancy: Twins or More,