What Is Multifetal Reduction?

Medically Reviewed by Traci C. Johnson, MD on April 23, 2023
3 min read

Fertility treatments raise your odds of getting pregnant with more than one baby. When you carry twins, triplets, or more, pregnancy becomes more of a challenge. It’s also less likely that all your babies will be born healthy.

A surgery called multifetal reduction lowers the number of fetuses and improves your chances for a healthy pregnancy. Also called fetal reduction or selective pregnancy reduction, it’s a safe procedure, and chances of problems are small. Still, it can be a tough decision.

The more babies in your womb, the more likely you are to have a miscarriage or a stillbirth, when the baby dies during the second half of your pregnancy or during birth. Another worry is that the babies can be born too early.

Premature delivery can cause problems with your babies' lungs, heart, stomach, and brain. They could also face lifelong health issues like cerebral palsy, intellectual disability, and vision and hearing loss.

Mothers who are pregnant with more than two babies at once can also have:

Usually, the procedure happens during the first trimester (12 weeks) of your pregnancy. That’s when the fetuses are still in separate fluid-filled pouches. Your doctor can look at the fetuses with an ultrasound probe. Using these pictures as a guide, your doctor will put a small needle in your belly or vagina, then gently inject a special drug into a pouch. This medicine quickly stops the fetus’s heart. Often, the doctor will reduce two fetuses.

Sometimes, your doctor will use a technique called radiofrequency ablation instead. A small needle device uses electric currents to cut off the blood flow from your umbilical cord to one or more fetuses.

Although fetal pregnancy reduction takes only a few minutes, you may get general anesthesia so you’ll sleep through it and feel no pain. Afterward, your doctor will do another ultrasound to check on the rest of your babies.

You may need to stay in the hospital overnight.

Infections from fetal reduction are rare. A small number of women can miscarry after the procedure. And you still might have a chance of going into labor too early.

To help the rest of your fetuses survive, your doctor will give you special instructions to follow during your pregnancy. These could include a diet high in calories and protein, medication, or extra bed rest. You may also need to check in with your doctor more often and extra tests to check your health and the health of your growing babies.

If you’ve been trying hard to get pregnant, you and your partner may feel sad and confused by the idea of fetal reduction. The need to decide quickly can add to your stress.

Tell your doctor your thoughts and questions. You also may want to talk to a counselor. Be open about your feelings. That will help you decide if this procedure’s right for you and your family.

Show Sources


The American College of Obstetricians and Gynecologists: “Multifetal Pregnancy Reduction.”

American Society for Reproductive Medicine: “Patient Fact Sheet: Complications and Problems Associated with Multiple Births.”

American Pregnancy Association: “Complications in a Multiple Pregnancy.”

Children’s Hospital of Wisconsin: “Multiple Pregnancy.”

Medical Journal of the Armed Forces of India: “Embryo Reduction: Our Experience.”

Human Reproduction: “Obstetric outcome and psychological follow-up of pregnancies after embryo reduction.”

Fetal Diagnosis and Therapy: “Outcome of Multifetal Pregnancy Reduction in Women with a Dichorionic Triamniotic Triplet Pregnancy to a Singleton Pregnancy: A Retrospective Nationwide Cohort Study.”

BJOG: an international journal of obstetrics and gynecology: “Radiofrequency ablation for selective reduction in complex monochorionic pregnancies.”

Children’s Memorial Hermann Hospital: “Radio-frequency Ablation.”

Sunflower Women’s Hospital: “Interventional Sonography.”

Mayo Clinic: “Placental Abruption,” “General Anesthesia.”

CDC: “Facts about Stillbirth.”

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