Técnicas usadas en la reducción del embarazo multifetal

Abstract

INTRODUCTION: Multiple pregnancies are defined as gestational pregnancies of two or more fetuses, and are characterized by the presence of numerous complications both during the gestation period and at the time of delivery. OBJECTIVE: To characterize the techniques used in reducing multifetal pregnancies, to provide better health care. METHODOLOGY: We conducted searches in academic and scientific databases, such as PubMed, Google Scholar and Scielo, using search terms such as "multiple pregnancy", "multiple pregnancy reduction", "high order pregnancy", "multifetal reduction techniques". We selected articles published in indexed journals during the period from 2018 to 2023, which specifically address the techniques used in reducing multifetal pregnancy. DEVELOPMENT: Among the methods used, to perform embryoreduction, is the injection of intracranial or intracardiac potassium chloride through the abdominal wall. However, their safety is not guaranteed due to possible transplacental transmission of potassium chloride to the twin who remains in monocorionic twin pregnancies. Radiofrequency ablation is used as a safe, efficient and minimally invasive technique. Embryo reduction is performed by inserting an ultrasound-guided needle, which allows the injection of a substance into the embryo or embryos selected to interrupt its development. CONCLUSION: The choice of the technique for fetal reduction in multifetal pregnancies depends on several factors, such as the viability of the fetus, the presence of congenital anomalies and the experience of the medical team.