Question

Your sister is pregnant with triplet embryos. Because of her small frame ,she has been advised that she will be unable to carry all three children to term and has to undergo a fetal reduction to remove at least one of them. Your sister asks you for your advice oh how to choose which one should be reduced. How would you respond?

Answer 1

Respect for patient autonomy is the basic principles and consideration to a woman’s right to hold views, make choices, and take actions related to her pregnancy management. It is also based on her personal values and beliefs and free of any compulsion .

The principles of beneficence and nonmaleficence are particularly complex and confusing when applied to the context of multifetal pregnancy. On the one hand, while considering multifetal pregnancy reduction may maximize the woman’s health and the health of her surviving neonates. But sometimes , multifetal pregnancy reduction does cause the loss of one or more fetuses and, in very rare condition it leads to the loss of the entire pregnancy. Therefore in this condition a patient values and beliefs may help her to make a decision either reducing or maintaining a multifetal pregnancy. The number of fetuses, the patient’s clinical history, the woman’s own values, and her particular economic and social situation may appropriately shift the balance regarding her to make the decisions. There always lies a complex balance of relative risks and benefits that compels the patient for the need of factual and comprehensive counseling regarding selective fetal reduction for women with multifetal pregnancies.So i would better suggest her to have a counselling rather than considering my thoughts.