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.

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.

Inclusion Criteria:

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

Exclusion Criteria:

• who do not give consent

Pregnant females with multiple pregnancy

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.