Multifetal pregnancy reduction. A review of an evolving technology and its psychosocial implications

Multifetal pregnancy reduction is the elective termination of gestation of a preselected number of fetuses in a multiple pregnancy to improve perinatal outcome. As improved techniques of infertility treatment are yielding more high-order multiple gestations, multifetal pregnancy reduction is being performed more frequently. The authors review the abundant literature on technique, the moderate amount of literature on ethics, and the minimal literature on the psychological consequences of this procedure, and describe the experience of the patients and their partners. The complexities of studying this area are discussed. Besides management of psychiatric complications, liaison psychiatrists could play an active role in structuring multifetal pregnancy reduction programs to optimize counseling and the patients' experience.