Trends of Selective Fetal Reduction and Selective Termination in Multiple Pregnancy, in England and Wales: a Cross-Sectional Study

Sam, Sreya; Tai-MacArthur, Sarah; Shangaris, Panicos; Sankaran, Srividhya

doi:10.1007/s43032-021-00819-5

Cited by 5 publications

(3 citation statements)

References 25 publications

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“…The aim of fetal reduction is not only to prolong pregnancy in MFP but also to selectively terminate fetuses with a congenital malformation 14 . Out of the total of 9 reduced twin pregnancies, 4 had a severe congenital malformation in one of the twins.…”

Section: Resultsmentioning

confidence: 99%

Transabdominal fetal reduction in higher order multiple pregnancies – A pioneer cohort retrospective study in Nepal

Paudel,

Dahal,

Pant

et al. 2024

Annals of Medicine &Amp; Surgery

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Objective: To share initial experience of transabdominal multifetal pregnancy reduction (MFPR) in Nepal. Method: The procedure was performed in 108 patients in a private hospital over a period of 3 years. Under ultrasound guidance, intracardiac injection of 0.2 to 3.0 ml of 15% w/v (2 mEq/mL) potassium chloride (KCl) was administered via transabdominal route. Results: A total of 108 fetal reduction procedures were carried out at the seventh to fifteenth weeks of gestation, a maximum of 44 (40.7%) of which were done at the ninth to tenth weeks of gestation. A total of 123 fetuses were reduced. Out of total 108 multifetal pregnancies, 96 (88.8%) were due to In Vitro fertilization (IVF). 85 pregnancies (78.7%) underwent reduction from triplet to twin. The second-time reduction was needed in 5 cases. Two attempts (in the same sitting) were required in 3 cases. Inadvertent demise of the second fetus was noted in 3 cases of dichorionic triamniotic triplet pregnancy. Conclusion: Ultrasound-guided transabdominal fetal reduction performed between the seventh and twelfth weeks of gestation is safe and effective.

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Section: Resultsmentioning

confidence: 99%

Transabdominal fetal reduction in higher order multiple pregnancies – A pioneer cohort retrospective study in Nepal

Paudel,

Dahal,

Pant

et al. 2024

Annals of Medicine &Amp; Surgery

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“…No more than 10 feticides were carried out using a laser during the whole study period. This method is, therefore, very rarely used for feticide in a singleton pregnancy, compared to multiple pregnancies where interstitial laser ablation was used for 6% of selective abortions in one study [15]. Interestingly, these methods are currently being used, although rarely, despite very little evidence for their use in feticide and that there are other options available with an evidence base.…”

Section: Methods Of Feticidementioning

confidence: 99%

Feticide Before Termination of Pregnancy in Singleton Pregnancy – Trends in England and Wales 2012-2020, a cross-sectional study

Schiff

Shangaris

Grinsted³

et al. 2023

Preprint

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Aim Feticide is the practice of inducing fetal demise before termination of pregnancy. In England and Wales, it is recommended for terminations of pregnancy beyond 21 + 6 weeks of gestation. This project analyses the trends in feticide in singleton pregnancy in England and Wales between 2012 and 2020. Methods This project was a retrospective study that analysed data extracted from the Health and Social Act 4 (HSA4) forms submitted to the Department of Health and Social Care (DHSC). The data extracted by the DHSC included the prevalence of feticide, methods of feticide and termination, statutory grounds, gestation, service provider, maternal age, ethnicity, and obstetric history. In addition, data analysis was carried out to identify trends. Results Between 2012 and 2020, there were 9310 feticides in England and Wales, used in 0.5% of all abortions. The prevalence of feticide fluctuated however, there was an overall decrease from 1084 cases in 2012 to 1000 cases in 2020. The most common method was intracardiac injection of potassium chloride (67.2%). Most feticides were performed before medical abortions (58.0%). 55.8% of feticides took place under Ground E of the Abortion Act 1967, and the main indication was congenital malformations of the nervous system. Most feticides occurred at 23 weeks gestation (40.2%) and in NHS hospitals (60.3%). Women undergoing feticide were mostly aged 30–34 years (38.3%) and of White ethnicity (78.6%). Conclusion Feticide is an essential component of comprehensive abortion care for women undergoing late second and third-trimester abortions. This study provides insight into how feticide is carried out in England and Wales and demonstrates the effect of the Covid-19 pandemic on feticide prevalence. Future research should analyse in more detail the use of the different methods of feticide.

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“…Over the last few decades, a small but increasing number of women have chosen to undergo multifetal pregnancy reduction from twins to singletons (2-to-1 MFPR) based on diverse reasons ranging from medical need to maternal autonomy 2 3. For some of these women, non-medical considerations such as psychological and socioeconomic factors play a more important role than medical factors in the decision to reduce twins to a singleton 4 5. Many believe that 2-to-1 MFPR is a reasonable consideration6 and will continue to increase i.…”

Section: Introductionmentioning

confidence: 99%

Fetal reduction, moral permissibility and the all or nothing problem

Wang

2023

J Med Ethics

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There is an ongoing debate about whether multifetal pregnancy reduction from twins to singletons (2-to-1 MFPR) is morally permissible. By applying the all or nothing problem to the cases of reducing twin pregnancies to singletons, Räsänen argues that an implausible conclusion seems to follow from two plausible claims: (1) it ispermissibleto have an abortion and (2) it iswrongto abort only one fetus in a twin pregnancy. The implausible conclusion is that women considering 2-to-1 MFPR for social reasonsought toabort both fetuses rather than just one. To avoid the conclusion, Räsänen suggests that it is best to carry both fetuses to term and give one for adoption. In this article, I argue that Räsänen’s argument fails for two reasons: the inference from (1) and (2) to the conclusion rests on a bridge principle that does not work in certain circumstances, and there is good reason to reject the claim that it is wrong to abort only one fetus.

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Trends of Selective Fetal Reduction and Selective Termination in Multiple Pregnancy, in England and Wales: a Cross-Sectional Study

Cited by 5 publications

References 25 publications

Transabdominal fetal reduction in higher order multiple pregnancies – A pioneer cohort retrospective study in Nepal

Transabdominal fetal reduction in higher order multiple pregnancies – A pioneer cohort retrospective study in Nepal

Feticide Before Termination of Pregnancy in Singleton Pregnancy – Trends in England and Wales 2012-2020, a cross-sectional study

Fetal reduction, moral permissibility and the all or nothing problem

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