Initial Experience of Transabdominal Fetal Reduction in Nepal

Transabdominal Fetal Reduction in Higher Order Multiple Pregnancies - a Pioneer Study in Nepal

Multifetal pregnancies are common in in vitro fertilization. Multifetal gestation increases maternal and fetal morbidity and mortality. We perform fetal reduction in our hospital by intra-thoracic injection of potassium chloride. This manuscript is description of our initial experience.

Study Overview

• Status: Completed
• Conditions: In Vitro Fertilization
• Intervention / Treatment: Drug: Fetal Reduction

Detailed Description

Assisted reproductive technology and stimulated conception have led to an increase in the prevalence of high order multifetal pregnancies (MFPs) in recent times. MFPs are associated with high maternal and fetal complications. Fetal mortality and morbidity are due to complications of prematurity. Prevalence of pregnancy induced hypertension, pre-eclampsia, eclampsia, antepartum hemorrhage, post-partum hemorrhage, gestational diabetes and difficult deliveries are more in mother with MFP. Embryo/Fetal reduction in high order MFPs helps in prolongation of gestation. Multifetal pregnancy reduction (MFPR) is secondary prevention of the risks associated with MFP. Trans-abdominal intracardiac injection of KCl is a simple, safe and effective technique for MFPR. We are among the first few centers in Nepal doing MFPR. In this study, we are sharing our initial experience of the procedure.

• Study Type: Observational
• Enrollment (Actual): 108

Contacts and Locations

Study Locations

• Nepal
  • Bagmati
    • Kathmandu, Bagmati, Nepal, Nepal
      • Prajwal Dahal

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Multifetal pregnancies referred from the obstetrics and gynecology department of our hospital, different other hospitals and in vitro fertilization (IVF) centers across the country underwent ultrasound-guided transabdominal embryo/ fetal reduction procedure between February 2018 to April 2023 in our department.

Description

Inclusion Criteria:

• pregnant females with multifetal gestation who opt to undergo fetal reduction

Exclusion Criteria:

• who do not give consent

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Transabdominal ultrasonography guided fetal reduction is safe and effective in first trimester	To share initial experience of transabdominal multifetal pregnancy reduction (MFPR) in Nepal	4.5 years

Collaborators and Investigators

• Sponsor: Grande International Hospital, Nepal
• Investigators: Principal Investigator: Sharma Poudel, MD, Grande International Hospital

Study record dates

Study Major Dates

• Study Start (Actual): February 1, 2018
• Primary Completion (Actual): April 30, 2023
• Study Completion (Actual): April 30, 2023

Study Registration Dates

• First Submitted: January 31, 2024
• First Submitted That Met QC Criteria: February 8, 2024
• First Posted (Estimated): February 9, 2024

Study Record Updates

• Last Update Posted (Estimated): February 9, 2024
• Last Update Submitted That Met QC Criteria: February 8, 2024
• Last Verified: February 1, 2024

More Information

Terms related to this study

• Keywords: In Vitro fertilization; Fetal reduction; Multifetal gestation
• Other Study ID Numbers: 20/2020

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No