Fetal Reduction in Vijayawada

You must be able to eat and drink normally beforehand. You need not need a full bladder before this test. Don't use any lotions, creams, or powders on your belly upon the day of the fetal echocardiogram.

Several studies have shown that multiple pregnancies which underwent fetal reduction had 60-70% reduction in early preterm delivery, reduction in neonatal mortality, higher birth weight, lower incidence of hypertensive disorders of pregnancy, lower rates of antenatal hospitalization.

1. Uncomplicated higher order multiple pregnancies
2. Discordant anomaly or aneuploidy ( If one fetus has structural or chromosomal abnormality and the other fetus is normal)
3. Advanced twin to twin transfusion syndrome
4. Severe early onset selective fetal growth restriction
5. Twin reversed arterial perfusion.

Fetal reduction can be performed in the first trimester or early second trimester We at our center, prefer to do it at around 12 weeks . The results of such tests might help patients in making their decisions about intervention.

Furthermore, around 8 to 20% multiple pregnancies might decrease by themselves by the end of the first trimester and fetal reduction is not required. The 'vanishing' twin will not have any adverse effects on the surviving fetus.

1. Confirm the chorionicity and amnionicity,
2. Rule out major structural abnormalities in the fetuses
3. Assess the growth of the fetuses
4. Measure nuchal translucency of the fetuses
5. Look for aneuploidy markers

Fetus with structural abnormality, very less growth or increased NT is reduced. If all the fetuses are equal in size and structurally normal with no aneuploidy markers, fetus that is easy to access is reduced.

Benefits and risks of performing the procedure are discussed with the couple in detail.Number of fetuses to be reduced depends on the type of multiple pregnancy and the choice of parents.

Consult Dr. P. Madhavi Latha who is the gynecology specialist in Vijayawada for best fetal medicine in Vijayawada

Abdomen (mother's tummy) is cleaned and draped. Fetus/es to be reduced are identified. 22G 15 cm needle is passed into the uterine cavity through the mother's abdomen under ultrasound guidance and aseptic precautions. KCL is injected into the thorax or heart of the fetus to be reduced and observed till the heart beat stops. Post procedure: Heart beats of the remaining fetus/es are checked.

Follow up check scan is done after 24 hours.

There might be slight bruising at the site of needle entry.

Few women may have mild cramping for couple of hours for which oral paracetamol can be taken.

There is no restriction to day to day activities. It is recommended to avoid doing heavy work that might increase intra-abdominal pressure.

There is no diet restriction

Obstetric medications can be continued.

Injection Anti-D is given to Rh negative mother within 24 hrs of performing procedure to prevent alloimmunization.

1. Procedure related fetal loss rate is 5-8%
2. Leaking per vaginum is seen in very few women (transient and mild )
3. Chorioamnionitis <0.1%
4. Fetal injury and serious maternal complications are rare are uncommon.