Multifetal pregnancy reduction is a process that doctors use toreduce the number of fetuses whenever there are multiple pregnancies.Normally, a pregnancy of three and more fetuses is deemed to bedangerous to the carrier, and there is always a need to reduce it totwo or one. High-order pregnancies (three or more fetuses) areextremely risky, as they may result in miscarriages, increase chancesof the fetuses suffering from lifelong disabilities, and even resultin stillbirths. The phenomenon of multiple pregnancies and theiroccurrence has been boosted by use of fertility drugs which areunregulated by qualified medical practitioners. Multifetal pregnancyreduction, thus, remedies some of the above challenges that areassociated with multiple pregnancies. The process increases chancesof successful and healthy pregnancies. The process, however, shouldbe done during the early moments of the pregnancy. It should also bedone by a specialized doctor who has experience and the requiredskills in the sector because it can be extremely risky. Although theinvention of this process has ensured an increase in the number ofsuccessful births, it has posed numerous challenges that ought to beovercome.
History ofMultifetal Pregnancy Reduction
The process of multifetal pregnancy reduction is a relatively newinvention, which was first in the late 1980s. During this time, InVitro Fertilization was discovered, its aim being to help infertilecouples sire children (Evans et al. 642).It was also seen as a positive move to bring to an end surrogacypractices that were as a result of infertility. However, theintroduction of In Vitro Fertilization proved to have more direconsequences. People opted to use it carelessly even when they wereaware of the risks involved. Moreover, the availability of thisfertilization technique meant that people ignored the advice to havemedical advice from medical practitioners when dealing with it. As aresult, the number of multiple pregnancies has been on the rise. Moreand more women were affected, with others having up to five fetusesat a go. Apart from the fertilization that was introduced, severalother factors influence the possibility of having multiplepregnancies. These may include a person’s age, heredity,medications that stimulate ovulations, among other factors. Becauseof the risk involved, a solution had to be found. Multifetalpregnancy reduction was introduced.
QuestionsUnder Active Investigation
Currently, there are several issues that have raised eyebrows whendealing with the concept of multifetal pregnancy reduction. Becausethis approach is relatively new, its literature is scarce, meaningthere is room to make a determination on many issues, both from thelegal and the medical perspective. The first issue that is beinginvestigated is whether the process has negative medical outcomes. Byits nature, MFPR’s role is to ensure there is a healthy birth,whether of one or two fetuses. The nature of the process entailsterminating the extra fetuses medically for one or two that arehealthy. Questions have always emerged as to whether the processguarantees such healthy births. Upon the extra pregnancies beingterminated, does the woman get an assurance that the remainingpregnancies will be healthy? Also, what are the effects of theprocess in subsequent pregnancies? These issues have been widelydebated about. Formigli and hiscolleagues argue that whereas the process is concerned with theimmediate danger posed to the subject, it increases the chances offuture complications in pregnancies (Formigliet al. 979). In their study, they found that the processesincreased the chances for future complications by 21 percent. Itwould seem that the process is not as successful as people deem it tobe. More and more people are carrying out experiments to understandthe connection between the two, with the aim of ensuring medicalcomplications do not arise as a result of MFPR.
Questions have also been raised pertaining the psychological outcomesof the process. By its nature, women subjected to MFPR face severaldifficulties. With the sole intention of the process being to achievea healthy birth, there is little focus given on the aftermatheffects. There is evidence that couples that undergo this processexperience emotional distress and grief as they feel that they havelost the other pregnancies. Moreover, there is no assurance that theprocess will be successful. There are instances where couples havelost all pregnancies in an attempt to reduce them. The causes ofthese are unknown. Many researchers are actively investigating theseissues to find the link and a possible solution to the challengesinvolved.
Current Statusof the Process
As already stipulated early, the MFPR process was first discovered inthe 1980s as a remedy for the increased cases of multiplepregnancies. Initial tests were done immediately, and the process wascertified safe and fit for human use. Ever since, the process hasbeen used in several situations to ensure that couples that face suchchallenges have a solution in an attempt to secure healthy births.Its usage, however, is restricted to medical practice, as opposed tocommercial purposes.
In effecting the process, physicians use potassium chloride in aprocess referred to as trans-abdominal multifetal pregnancyreduction. By using a needle, the doctor injects the potassiumchloride solution to the selected fetus, killing it instantly.Because the fetus is still small, it is absorbed into the bloodstreamof the woman. It may also come out as a vaginal fluid (Mittal303). The termination increases the chances of theremaining fetuses to grow without deformities.
The process is tricky and highly risky, a reason it should be done byan informed doctor. Besides, there is a need to perform this processat the earliest opportunity possible when the fetus is small.Procrastinating until the fetus matures poses challenges to both thefetus and the mother. When the fetus is small, killing it ensures itgets absorbed by the body of the mother. It may then come out in theform of vaginal bleeding, similar to what happens in the vanishingtwin syndrome. The process has been embraced in several countries asit is seen as the only medical way through which couples withmultiple pregnancies can be assured of having healthy births. The waythe process is carried out is very delicate and may have apsychological effect on the couple involved. As already argued, theprocess has a high chance of resulting in post-reduction traumabecause the mother may feel she lost/killed or terminated apregnancy. Because of this psychological trauma, there is a need toensure that proper counseling is availed to the victims. Moreover,the practice should be done by consent.
Scientific/MedicalProblems Associated with the Work
The multifetal pregnancy reduction process is extremely risk andshould be used as the last option. Although high rates of successhave been recorded when the process is used to achieve healthybirths, there are circumstances that leave a more adverse effectafter the process. The first problem is about the period when thisprocess is carried out. As already explained, the process entailsinjecting the fetus with a solution of potassium chloride, therebykilling it. It is then absorbed into the body and released in theform of vaginal fluids. The process can be tricky and extremelydangerous if done in the later stages of pregnancy. During thisperiod, the development of the fetus would have taken place, and itwould be difficult to absorb them into the mother’s body. Injectingthem with the solution will only result in them dying, but it will bedifficult for them to be washed away from the womb of the mother. Ifthis happens, it may threaten or endanger the life of the mother(Formigli et al. 980).
The process is not extremely safe when being implemented. Ifundertaken by an unqualified person who has no adequate skills on howto undertake it, it may result in injecting the wrong fetus, therebycausing more harm. There are cases where doctors have mistakenlyreleased the contents of the needle to the body of the mother insteadof directing them to the targeted fetus. Potassium chloride isextremely dangerous and has adverse effects on a person’s life. Moreover, there is evidence that the process increases the chances ofaffecting future pregnancies, meaning it may render the subjectinfertile. Because of all these, it is important that utmost care isobserved when implementing the process.
Who theTechnology Is Used On
Ever since the multifetal pregnancy reduction process was incepted,it has been used severally to save lives. The beneficiaries of theprocess are women with multiple pregnancies that may cause harm orlead to giving birth to unhealthy babies. Over time, physicians havebeen tasked to implement the process because of their medical skills(Monteagudo et al. 339). Although theprocess may look simple to implement, it has to be done by aqualified physician to minimize the chances of causing more harm tothe subject.
The number of fetuses involved in the pregnancy in question should beconsidered when making a decision whether to participate in theprocess or not. Women with more than two fetuses are advised toembrace this approach to enable them to control their pregnancies.Factors such as emotional concerns, financial muscles, and evenmedical risks when undertaking the process are considered. Althoughthe process is implemented on the women with multiple pregnancies, itis important to have the consent of their husbands to ensure it isagreed and that no legal issues will arise. In some cases, theprocess has been used to procure abortions. This is illegal andpunishable by the law. Its usage, thus, should be founded by amedical situation where the pregnancy threatens the life of themother, or where there are chances that carrying all the fetus willresult in unstill births.
Mitigating psychological Trauma after MFPR process
As already noted, the multifetal pregnancy reduction is a painfulexperience, both physically and psychologically. Mothers who aresubjected to a situation where they have to consent to get rid oftheir pregnancies on account that such pregnancy is a threat do notfind it easy to cope. This may subject them to unprecedented trauma,and may lead them to take adverse steps. To mitigate this, there is aneed to have in place adequate mechanisms to counsel them to settle.
Counselling for these type of women should commence immediately adoctor gets to know of a high-order multi-fetal pregnancy (Formigli779). One should not wait until the exercise is over in orderto counsel them. During this time, the counselling offered shouldensure the patient has full information about the necessity to havethe MFPR process and why they should not feel guilty. It is importantto advise them on the possible negative effects if they do notundertake such a process. This type of counselling should be offeredby a professional. These may include: neonatologists,perinatologists, and mental health professionals (Mittal300).
In addition to the counselling services that the patient is exposedto, it is important to provide them with other medicalrecommendations. These may include drugs and related therapies thatwill help them cope in a quick manner. At all times, the patientsshould be treated carefully in order to help them cope. Subjectingthem to stress will only worsen the situation. If these are kept,then the patients will have better chances to cope and accept theeventuality.
To sum up, it is evident that the multifetal pregnancy reductionprocess is useful in helping women with high-order pregnancies. Without this process, women may be forced to use archaic methods thatwould endanger them. This activity should be undertaken by aqualified physician if positive results are to be expected.
Evans, Mark I., and David W. Britt."Multifetal Pregnancy Reduction and SelectiveTermination." Management ofUnintended and Abnormal Pregnancy (2014):312-318. Print.
Formigli, L. "Multifetal pregnancyreduction: Multifetal pregnancy reduction: a useful tool, but adifficult choice." HumanReproduction 9.11 (2014):979-980. Print.
Mittal,Shweta. "Chapter-18 Selective Multifetal PregnancyReduction." Stepby Step Ovulation Induction (2014):299-308. Print.
Monteagudo, A., and I. E. Timor-Tritsch."An approach to multifetal pregnancy reduction in a pregnancy ofgrand order (12 fetuses)." Ultrasoundin Obstetrics & Gynecology 4.4 (2013):339-341. Print.