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Dr. Singh
Test Tube Baby Centre
Multiple Pregnancy- Adverse effects and its treatment
Multifetal pregnancy reduction (MFPR) is procedure used to reduce the number of fetuses in a multiple pregnancy.
The increased use of assisted reproductive technology (ART) has led to a dramatic increase in the incidence of multifetal births in last several decades. This problem is going down now due to policy of single embryo transfer.
The risks of perinatal as well as maternal morbidity and mortality increase with the presence of each additional fetus. Despite technologic advancements in neonatology, there has been no reduction in mortality for infants born.
Multifetal xHkkZoLFkk esa deh ¼,e,Qihvkj½ ,d çfØ;k gS tks dbZ xHkkZoLFkk esa H:.k dh la[;k dks de djus ds fy, mi;ksx dh tkrh gSA lgk;d çtuu rduhd ¼,vkjVh½ ds c<+rs mi;ksx ls fiNys dbZ n'kdksa esa cgq&H:.k tUe dh ?kVukvksa esa ukVdh; o`f) gqbZ gSA ,dy H:.k LFkkukarj.k dh uhfr ds dkj.k vc ;g leL;k uhps tk jgh gSA
çR;sd vfrfjä H:.k dh mifLFkfr ds lkFk çlo ds lkFk&lkFk ekr` e`R;q vkSj e`R;q nj dk tksf[ke c<+rk gSA uotkr foKku esa rduhdh&rdZ çxfr ds ckotwn] iSnk gq, f'k'kqvksa ds fy, e`R;q nj esa dksbZ deh ugha gqbZ gSA
Complications of Multiple Pregnancy
A. Infant Risks
Infants born as part of a multiple pregnancy are at increased risk of
1. Prematurity
2. Cerebral palsy
3. Learning disabilities, slow language development, behavioral difficulties
4. Chronic lung disease, development delay and death
5. Premature Loss
The risk of spontaneous loss of the entire pregnancy is 25% for quadruplets, 15% for
B. Maternal risks of multifetal pregnancies
1. Hypertension
2. Preeclampsia
3. Gestational diabetes
4. Postpartum hemorrhage
5. There also are significant economic adverse effects of multiple pregnancies, such as .......the need for additional child care, greater household and medical expenditures.
Multiple births are much more common today than they were in the past. According to the US Department of Health and Human Services, the twin birth rate has increased by over 75% and triplet, quadruplet, and high-order multiple births have increased at an even higher rate. There are more multiple births today in part because more women are receiving infertility treatment…
vesfjdh LokLF; vkSj ekuo lsok foHkkx ds vuqlkj] tqM+oka tUe nj esa 75% ls vf/kd dh o`f) gqbZ gS vkSj rhu xquk] pkSxquh] vkSj mPp Øe ,dkf/kd tUe ,d mPp nj ij c<+ x, gSaA vktdy dbZ lkjs tUe gSa D;ksafd vf/kd ls vf/kd efgyk,a cka>iu mipkj çkIr dj jgh gSaA
Treatment of Multiple Pregnancy – Foetal Reduction
The reduction procedure is generally carried out during the first trimester of pregnancy. Under Ultrasound Guide Trans-Vaginally or Trans-abdominally.
The most common method is to inject 0.4-0.8 mL potassium chloride (KCl) 15% w/v 2 mEq/mL into the fetus’s heart; 1 the heart stops and the fetus dies as a result.
Generally, the fetal material is reabsorbed into the women ’s body.
vYVªklkmaM xkbM Vªkal&oSfxuyh ;k Vªkal&isVh ds rgr xHkkZoLFkk ds igys frekgh ds nkSjku vkerkSj ij reduction dh çfØ;k dh tkrh gSA
lcls vke rjhdk H:.k ds fny esa 0-4&0-8 ,e,y iksVsf'k;e DyksjkbM ¼dslh,y½ 15% MCY;w/oh 2 ,ebZd/,e,y batsDV djuk gSA fny can gks tkrk gS] rks mlds ifj.kkeLo:i H:.k ej tkrk gSA vke rkSj ij] H:.k lkexzh dks efgykvksa ds 'kjhj esa iqu% LFkkfir fd;k tkrk gSA
Risk of Foetal Reduction
While the procedure generally reduces the over-all risk level for the remaining fetus or fetuses, reduction does have its own risks, including the possibility that remaining fetuses will abort or die after the procedure with worldwide loss rate of 4.7%.
gkykafd çfØ;k vke rkSj ij 'ks"k H:.k ;k H:.k ds fy, vf/kd tksf[ke Lrj dks de dj nsrh gS] ysfdu dVkSrh ds vius tksf[ke gksrs gSa] ftlesa laHkkouk gS fd 'ks"k H:.k 4-7% dh fo'oO;kih gkfu nj ds lkFk çfØ;k ds ckn fujLr ;k ej tk,axsA
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