[High grade multiple pregnancy--a clinical and ethical problem in reproduction medicine]

24 patients with high grade multiple pregnancy were admitted to the Department of Obstetrics of the Grosshadern Hospital of the University of Munich between 1984 and 1988. Aetiology, clinical findings and neonatal outcome are presented. With this data as background, the main part of the paper presents and discusses critically three methods of solving this difficult medical and psychosocial problem: 1. prevention, 2. abortion, and 3. foeticide. It is shown that in contrast to killing following prenatal diagnosis, foeticide in high grade multiple pregnancy is unselective. Since every new medical possibility will soon be demanded by society after suitable sociopsychological persuasion and inducement, it is practically an ethical imperative to rightaway prevent high grade multiple pregnancy from occurring.