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.
Why It’s Done
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:
- Severe morning sickness
- Constipation
- Diabetes
- Preeclampsia (high blood pressure)
- Anemia
- Placental abruption (a serious condition in which your placenta separates from your uterus)
How It’s Done
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.
Potential Problems and Aftercare
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.
Get Advice
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.