Multiple pregnancies have been increasing as a result of the, relatively widespread use of ovilatory drugs and in vitro fertilization(IVF). In multiple pregnancies, adverse outcome is directly proportional to the number of fetuses-within the uterus, primarily because. of an increased predisposition to premature delivery. It is extremely difficult to counsel patients about the expected outcome of pregnancies involving three or more fetuses. To increase the chances of delivering infants mature enough to survive without being irreversibly damaged by the seguelae of marked prematurity, selective abortion to the smaller number of fetuses may be considered in multiple pregnancies.
In 22 patients including 13 triplet; 7 quadruplet, 1 quintuplet and I heptuplet pregnancies, transabdominal selective abortion was performed from January, 1991 to July, 1992. Selective abortion was carried out in 8?13 weeks of gestation. After procedure, 20 patients were remained as twin pregnancies. and 2 patients as triplet There have been 10 sets of twins, 2 triplets, and I singleton delivered. One twin pregnancy is ongoing, and 4 cases were aborted. Seven losses of pregnancy including one case of septic abortion occurred with the delayed fetal loss rate of 38.9 % (7/18). Five cases were delivered after 37 weeks of gestation, 4 cases in 33?37 weeks. and 4 cases in 20?33 weeks. All babies were healthy after birth in patients after 33 weeks of gestation. No fetal anomaly directly related to the procedure was encountered.
In conclusion, selective abortion is a rather safe and ethically justified procedure that may improve the outcome of multiple pregancies.
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