Nursing considerations in the case of multifetal pregnancy reduction

This article concerns the issue of multifetal reduction performed in some cases of higher order multiple gestation in order to decrease the possibility of adverse pregnancy outcomes and increase the chances of survival in the remaining fetuses. If multifetal pregnancy reduction is considered as a treatment option, it is usually performed in the first or early second trimester. The decision to reduce one or more fetuses is extremely complicated, and numerous factors must be considered, since the procedure has risks, such as loss of the entire pregnancy or preterm labor and birth of the remaining fetuses. In addition, there are also psychological risks for the mother. Typically women faced with this decision have struggled for years with infertility and now they are asked to consider terminating one or more of the fetuses to prevent morbidity and/or mortality in others. Nurses who work with infertile women may be able to assist in minimizing the need for multifetal pregnancy reduction by educating women about the risks associated with assisted reproductive technologies and higher order multifetal pregnancy before decisions are made about multiple embryo transfers or intrauterine insemination after ovulation induction.