Selective reduction of multifetal pregnancies in the first trimester using colour Doppler ultrasonography

In pregnancies with multiple gestation, an 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 multifetal reduction in triplets and quadruplets and even quintuplets, there is very little on sextuplets, and virtually nothing on septuplets. Among the different techniques proposed for selective termination, two approaches have been more widely adopted: transcervical aspiration and transabdominal needling of the embryo using grey scale ultrasonography, but as yet there is no report on multifetal reduction using colour Doppler ultrasound. A method for selective termination of multiple pregnancy using transabdominal colour Doppler ultrasonography has been described here for the first time in a case of septuplets.