Selective fetocide procedure

Selective foetocide procedure in clinics in Israel and Germany

Selective fetocide is a medical procedure that results in the intrauterine death of one or more foetuses. This procedure is performed for special indications, in multiple pregnancies.

A pregnancy with two or more fetuses is called a multiple pregnancy. Unfortunately, not always carrying several babies is a happy and safe event. In some cases, there are cases where one twin foetus has severe or multiple malformations (incompatible with life or potentially causing severe disability).

There have also been cases of feto-fetal haemotransfusion syndrome, where one recipient foetus (a ‘parasitic’ foetus with multiple malformations incompatible with life) is fed by a donor foetus (potentially healthy). Carrying such a pregnancy without intrauterine intervention results in the death of both fetuses. One possible tactic is to perform selective fetocide (intrauterine fetal death) by ligation of the umbilical cord or injection of potassium chloride into the cardiac cavity. The indications for such a procedure are medical-maternal. That is, it is not only the analyses and the medical report, but also the will of the mother that is decisive in this situation.

Fetocide with potassium chloride solution.

It is performed in women with bichorionic twins (the foetuses have different placentas) if there are certain indications. The timing of this procedure is determined by the doctor. The procedure of selective fetocide can be carried out in leading medical centres in Germany and Israel. Experienced specialists confirm the diagnosis and carry out the procedure with minimal risks for the second foetus and the woman.

The basic programme of examination of women for the purpose of selective fetocide in clinics in Germany and Israel includes the following:

1.Examination by specialised specialists: obstetrician-gynaecologist and perinatal geneticist.
2.Conducting a clarifying ultrasound (sonography) fetuses.
3.If indicated, amniocentesis and chorionic villus biopsy.
4.General clinical examinations (general blood analysis, biochemical blood analysis, general urine analysis, blood group and Rh factor).
5.Performance of selective fetocide procedure.

Methodology of selective fetocide procedure with potassium chloride solution.

Under ultrasound control, the right ventricle of the foetus is punctured through the anterior abdominal wall of the mother. A certain amount of potassium chloride solution is injected into the ventricular cavity, which leads to cardiac arrest of the foetus. Within a day, a control ultrasound is carried out.

In the future, the woman should be under the supervision of an obstetrician-gynaecologist in a women's clinic or fertility centre, in the country where the fetocidal procedure was carried out or at the place of residence. Before discharge, the woman receives an extract from her medical record, including all laboratory tests, ultrasound and the protocol of the procedure.