Diachorionic Triamniotic Triplets—Saline Cardiac Tamponade for Fetal Reduction: A Novel Approach

Abstract

Artificial reproductive techniques are helping the infertile couples to conceive but with an inherent risk of multifetal pregnancy. Multifetal pregnancies more so; multiple monochorionic pregnancies endanger both the fetus and the mother with an increased risk for morbidity and pregnancy loss. The reduction of multifetal pregnancy using Potassium chloride (KCl) is a usual procedure to reduce multiple pregnancies; but gets complicated in case of monochorionic multiple pregnancies like diachorionic trimnioitc triplets in which KCl cannot be used. In this scenario, the usual procedure for fetal reduction might endanger both the fetuses with common placenta (monochorionic twins). Normal saline was used to create cardiac tamponade to achieve cardiac asystole, which is a novel way of reducing the multiple fetuses with common placentas without an adverse effect on the other co-twin and effect of maternal spillage of the drug commonly used.

Keywords

Artificial - Multifetal - Monochorionic - Dichorionic diamniotic - Triplets - KCl - Saline