IMPROVED TECHNIQUES FOR FIRST-TRIMESTER FETAL REDUCTION USING SIMULTANEOUS ABDOMINAL AND TRANSVAGINAL ULTRASONOGRAPHIC GUIDANCE - PRELIMINARY-REPORT

Simultaneous transabdominal injection of potassium chloride (KCl) assi sted by transvaginal ultrasonographic guidance was evaluated in 5 pati ents who conceived due to various assisted reproductive techniques and ovarian stimulation. All 5 underwent first-trimester fetal reduction for multiplicity of high-order pregnancies. Four sets of triplets were reduced to twin, and 1 twin pregnancy was reduced to a singleton. Les s than 2 ml of 2 mEq/ml KCl per fetus was needed for each case. No fet al or maternal complications nor technical failure attributable to the procedure were recorded. All pregnancies were delivered greater than or equal to 35 weeks of gestation. Transabdominal fetal reduction usin g simultaneous transvaginal ultrasonographic guidance for selective fe ticide combines the benefits of both the transabdominal and transvagin al approaches, mainly in selected cases in which some experts prefer t he abdominal route, but find it technically difficult to practice. Fur ther experience is needed to confirm our encouraging prelim:inary resu lts before drawing any definitive conclusions.