First-trimester selective termination in multiple gestation by transvaginal ultrasound-guided intrathoracic injection of potassium chloride.

ABSTRACT

PATIENTS AND METHODS: Selective termination by transvaginal ultrasound-guided intrathoracic injection of potassium chloride (KC1) was performed between 8 and 10 weeks' gestation in eight women with multiple gestation after ovulation induction (6/8) or in vitro fertilization (IVF) (2/8). RESULTS: Four patients have delivered uneventfully at term, one delivered prematurely at 34 weeks' gestation with good neonatal outcome, and the other 3 patients lead a smooth pregnancy at present. No pregnancy loss or any major complication was found. CONCLUSIONS: Transvaginal ultrasound-guided intrathoracic injection of KC1 may be the procedure of choice for first-trimester selective termination with acceptable safety. However, more experience is needed to clarify the risk/benefit ratio associated with this procedure.