Selective Reduction of Multifetal Pregnancies

To the Editor: Berkowitz et al. (April 21 issue)* have thoughtfully reviewed the medical and social problems associated with multifetal pregnancies. In their experience, a “selective reduction procedure” offered to carefully counseled women can convert a multifetal gestation (three to six fetuses) to either a twin or a triplet pregnancy and thereby improve the prognosis for the delivery of viable neonates. In experienced hands, the techniques and the carefully implemented protocols represent admirable options with the potential to reduce known but unpredictable maternal and fetal complications that threaten the outcome of “desperately wanted” pregnancies. A more appropriate title for the.