Selective Reduction of Multifetal Pregnancies in the First Trimester

THE number of pregnancies complicated by multiple gestation has been increasing as a result of the relatively widespread use of ovulatory drugs and in vitro fertilization. In pregnancies with multiple gestations, adverse outcome is directly proportional to the number of fetuses within the uterus, primarily because of an increased predisposition to premature delivery. Although there is a good deal of information about the gestation of twins, there is very little on triplets, and virtually nothing but case reports have been published on pregnancies involving four or more fetuses. It is therefore extremely difficult to counsel patients about the expected outcome . . .