Selective feticide of an affected fetus in the second trimester has comparable risks to those in the first trimester.

The broad acceptance of prenatal diagnosis of various genetic diseases leads to an ever-increasing number of parturients with twin gestations undergoing selective feticide of an affected fetus. In most of the cases, delayed diagnosis leads to second trimester reduction. The aim of the present study was to investigate whether this procedure can be performed in the second trimester with results comparable to those obtained when it is performed in the first trimester. There was a 5.6% miscarriage rate in the group reduced in the first trimester (n=18, Group A) and an 8.3% miscarriage rate in the group reduced in the second trimester (n=48, Group B). The mean weight of neonates in the first group was 2780 g, and in the second group 2620 g. The mean gestational age at delivery was 36.7 weeks for Group A and 35.1 weeks for Group B. No significant differences were observed for any two-paired values considered. There was no perinatal mortality in either group. We therefore conclude that selective feticide of an affected fetus is as safe in the second trimester as it is in the first.

Reduction of multifetal pregnancies to twins does not increase obstetric or perinatal risks.

Selective reduction in cases of multiple fetuses is used more often nowadays due to the increased number of multiple pregnancies resulting from assisted reproduction. In this retrospective study, we investigated whether twin pregnancies derived from fetal reduction carry a higher obstetric and perinatal risk compared to standard twin pregnancies. We found that the rate of miscarriage was 10.6% in the reduction group (n = 158) compared to 9.5% in the controls (n = 135). Mean gestational age at delivery was 35.7 weeks in the reduction group versus 35.1 weeks in the control group. Mean neonatal weight at birth was 2.260 g (800-3.750 g) in the reduction group compared to 2.240 g (540-3.360 g) in controls. Perinatal mortality rate was 49.3 per thousand after reduction and 42.0 per thousand in the control group. There was no statistically significant difference in any of the above parameters. Therefore, multifetal pregnancy reduction to twins does not appear to increase obstetric or perinatal risks.