Selective termination for fetal anomaly/genetic disorder in twin pregnancy at 32+ menstrual weeks. Report of four cases.
OBJECTIVE
To conduct a pilot study of 4 cases of selective termination of a single abnormal fetus in a dichorionic, diamniotic twin pregnancy advanced to 32 or more menstrual weeks of gestation.


METHODS
This is a case series of 4 patients in highly unusual circumstances and treatment. Four healthy patients with desired pregnancies complicated by the presence of an abnormal genetic or developmental diagnosis in 1 twin were treated by selective termination of the abnormal twin using intracardiac injection of potassium chloride.


RESULTS
In all 4 patients, cardiac arrest in the abnormal twin was effected without disturbance of the healthy twin or the mother. Postoperative maternal serum potassium levels remained at normal levels. Delivery of a healthy surviving twin occurred from 2 days to 4 weeks following the selective termination along with delivery of a stillborn abnormal twin.


CONCLUSIONS
Selective termination of an abnormal twin may be performed on an outpatient basis in the last weeks of pregnancy.
Hern
Warren M
WM
Boulder Abortion Clinic and Department of Obstetrics and Gynaecology, University of Colorado Health Sciences Center, CO, USA. bachern@drhern.com
D000553:Ambulatory Care; D005260:Female; D005315:Fetal Diseases / Q000235:genetics*; D005333:Fetus / Q000002:abnormalities*; D006321:Heart / Q000187:drug effects; D006801:Humans; D007267:Injections; D010865:Pilot Projects; D011189:Potassium Chloride / Q000008:administration & dosage; D011247:Pregnancy; D018607:Pregnancy Reduction, Multifetal; D011263:Pregnancy Trimester, Third; D011272:Pregnancy, Multiple; D014427:Twins
D011189:Potassium Chloride