Clinical case of selective reduction of a fetude with Down syndrome in multiple pregnancy (twins)

Background. In recent decades, the prevalence of multiple pregnancies has increased significantly worldwide, including in the CIS countries. This is due to both general demographic and social changes, as well as the active introduction of assisted reproductive technologies, among which in vitro fertilization is of particular importance. An increase in the number of multiple pregnancies inevitably leads to an increase in the frequency of complications, which underlines the importance of developing and improving methods aimed at reducing perinatal risks.
Results. Are view of the literature on the methods, timing, and results of selective reduction of a fetus with hereditary and congenital pathology in multiple pregnancies is presented. The authors' own results of selective reduction of a fetus using potassium chloride are described. Detailed information on the implementation of selective reduction of a fetus with Down syndrome in the second trimester of pregnancy following in vitro fertilization is presented. The tactics of medical and genetic counseling of the family and pregnancy management, the need for a control analysis of the karyotype of the reduced fetus to exclude procedural errors are discussed.
Conclusion. Selective reduction is an effective and clinically proven method to reduce the number of fetuses and thereby reduce the incidence of complications, improve perinatal outcomes and ensure a more favorable course of pregnancy. The correct choice of the timing of the intervention, careful preparation and multi-stage counseling of the patient significantly increase the safety and effectiveness of the method

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