Review Note
Last Update: 07/22/2024 06:03 AM
Current Deck: - ALL SAR 1 ANKI Decks -::Medace Qbank
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Front (Question)
A 28-year-old woman is seen for her first obstetric visit. Her LMP was 8 weeks ago. Her history is significant for infertility due to chronic salpingitis and she required in vitro fertilization (IVF) with multiple embryo transfer. A serum pregnancy test is positive. A transabdominal ultrasound shows an enlarged uterus containing five viable fetuses. You advise her that the optimal outcome can be achieved only with which of the following?
- close supervision embryo reduction intramuscular prostaglandin progestin therapy termination of the pregnancy
Back (Answer)
embryo reduction
The incidence of multifetal pregnancies has risen dramatically with increased use of agents for ovulation induction and transfer of multiple embryos during IVF. Generally, the number of fetuses is inversely related to pregnancy duration and birth weight. This patient has a grand multi-fetal pregnancy, defined as four or more embryos. She has a significant risk of developing pregnancy complications (including preterm delivery and pregnancy-induced hypertension) leading to low-birthweight infants and high perinatal mortality. Although this case presents several ethical dilemmas, the patient should be offered selective termination, a technique in which the number of fetuses is reduced. It is commonly performed by ultrasound-directed transcervical injection of potassium chloride into the fetal thoracic cavity.
The incidence of multifetal pregnancies has risen dramatically with increased use of agents for ovulation induction and transfer of multiple embryos during IVF. Generally, the number of fetuses is inversely related to pregnancy duration and birth weight. This patient has a grand multi-fetal pregnancy, defined as four or more embryos. She has a significant risk of developing pregnancy complications (including preterm delivery and pregnancy-induced hypertension) leading to low-birthweight infants and high perinatal mortality. Although this case presents several ethical dilemmas, the patient should be offered selective termination, a technique in which the number of fetuses is reduced. It is commonly performed by ultrasound-directed transcervical injection of potassium chloride into the fetal thoracic cavity.
Note (Extra)
Reference
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c988c28d-b40e-4c3a-b744-f73a099535c3
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