Selective termination of the anomalous fetus in multifetal pregnancy

When an anomaly is diagnosed in one fetus in a multifetal pregnancy, parents can be offered the choice of selective termination of the anomalous fetus. In dizygotic twins, fetal intracardiac injection of potassium chloride (KCI) is the preferred method. Technically, it can be performed in all three trimesters with good outcome in > 90% of cases. In monochorionic twins, KCI injection is precluded owing to the possible vascular communications between the fetuses. Selective termination in these cases can be performed by occluding the cord of the target fetus, using either cord ligation, laser coagulation or bipolar coagulation.