Selective reduction
Encyclopedia
Selective reduction is the practice of aborting
one or more fetus
es in a multifetal pregnancy. Such an abortion procedure is often performed after a congenital defect has been identified. Prenatal diagnostic testing may determine that some fetuses have chromosomal defects or a greater chance of genetic diseases, and those fetus(es) are then targeted in selective reduction.
Selective reduction is also used to reduce a higher-order multiple pregnancy (one with three or more fetuses) to a twin or singleton pregnancy. This is done to avoid the medical issues generally related to multiple births, including premature birth
s, low birth weight
s, and associated medical problems. Selective reduction can also be used to reduce a twin pregnancy to a singleton one, but this is less common as the risks in twin pregnancies, while existent, are much lower than in higher-order multiple pregnancies.
In many cases this type of multifetal reduction is chosen by couples who used fertility treatment
s that resulted in a multifetal pregnancy.
into the fetus's heart; the heart stops and the fetus dies as a result. Generally, the fetal material is reabsorbed into the woman's body. While the procedure generally reduces the over-all risk level for the remaining fetus or fetuses, reduction does have its own risks, including the possibility that one or more of the remaining fetuses will also die.
Dr. Mark Evans, a New York City-based obstetrician-geneticist, and a group of doctors, developed the procedure for selective reduction in the 1980s.
Abortion
Abortion is defined as the termination of pregnancy by the removal or expulsion from the uterus of a fetus or embryo prior to viability. An abortion can occur spontaneously, in which case it is usually called a miscarriage, or it can be purposely induced...
one or more fetus
Fetus
A fetus is a developing mammal or other viviparous vertebrate after the embryonic stage and before birth.In humans, the fetal stage of prenatal development starts at the beginning of the 11th week in gestational age, which is the 9th week after fertilization.-Etymology and spelling variations:The...
es in a multifetal pregnancy. Such an abortion procedure is often performed after a congenital defect has been identified. Prenatal diagnostic testing may determine that some fetuses have chromosomal defects or a greater chance of genetic diseases, and those fetus(es) are then targeted in selective reduction.
Selective reduction is also used to reduce a higher-order multiple pregnancy (one with three or more fetuses) to a twin or singleton pregnancy. This is done to avoid the medical issues generally related to multiple births, including premature birth
Premature birth
In humans preterm birth refers to the birth of a baby of less than 37 weeks gestational age. The cause for preterm birth is in many situations elusive and unknown; many factors appear to be associated with the development of preterm birth, making the reduction of preterm birth a challenging...
s, low birth weight
Low birth weight
Low birth weight is defined as a birth weight of a liveborn infant of less than 2,500 g. regardless of gestational age-Causes:LBW is either the result of preterm birth or of the infant being small for gestational age , or a combination of...
s, and associated medical problems. Selective reduction can also be used to reduce a twin pregnancy to a singleton one, but this is less common as the risks in twin pregnancies, while existent, are much lower than in higher-order multiple pregnancies.
In many cases this type of multifetal reduction is chosen by couples who used fertility treatment
Assisted reproductive technology
Assisted reproductive technology is a general term referring to methods used to achieve pregnancy by artificial or partially artificial means. It is reproductive technology used primarily in infertility treatments. Some forms of ART are also used in fertile couples for genetic reasons...
s that resulted in a multifetal pregnancy.
Practice
The reduction procedure is generally carried out during the first trimester of pregnancy. The most common method is to inject potassium chloridePotassium chloride
The chemical compound potassium chloride is a metal halide salt composed of potassium and chlorine. In its pure state, it is odorless and has a white or colorless vitreous crystal appearance, with a crystal structure that cleaves easily in three directions. Potassium chloride crystals are...
into the fetus's heart; the heart stops and the fetus dies as a result. Generally, the fetal material is reabsorbed into the woman's body. While the procedure generally reduces the over-all risk level for the remaining fetus or fetuses, reduction does have its own risks, including the possibility that one or more of the remaining fetuses will also die.
Dr. Mark Evans, a New York City-based obstetrician-geneticist, and a group of doctors, developed the procedure for selective reduction in the 1980s.
See also
- AbortionAbortionAbortion is defined as the termination of pregnancy by the removal or expulsion from the uterus of a fetus or embryo prior to viability. An abortion can occur spontaneously, in which case it is usually called a miscarriage, or it can be purposely induced...
- Assisted reproductive technologyAssisted reproductive technologyAssisted reproductive technology is a general term referring to methods used to achieve pregnancy by artificial or partially artificial means. It is reproductive technology used primarily in infertility treatments. Some forms of ART are also used in fertile couples for genetic reasons...
- Sex-selective abortion and infanticide