Comparison of Intracardiac and Intrathecal KCL Application as an Alternative Method in the Reduction of Multiple Pregnancies in the First Trimester: Results of a Tertiary Centre

Abstract

INTRODUCTION: This retrospective study compares the outcomes of intracranial (IC) and intrathoracic (IT) potassium chloride (KCl) applications for fetal reduction in multiple pregnancies.
METHODS: Nineteen patients undergoing termination between December 2022 and November 2023 were analyzed. Transabdominal IC (n=8) and IT (n=11) KCl groups were compared for maternal age, gestational age, indication for reduction, and procedural details. P-values <0.05 were interpreted as statistically significant.
RESULTS: While both groups exhibited similar maternal characteristics, the number of fetuses before reduction differed significantly (p=0.016). No significant distinctions were observed in operative time, reduction outcomes, or obstetric complications between the IC and IT groups (p>0.05). Premature rupture of membranes occurred in 13.3% (IT) and 23.1% (IC), with no significant intergroup differences.
DISCUSSION AND CONCLUSION: The study suggests that IC KCl application may be a viable alternative, potentially simplifying the procedure without compromising safety or efficacy. The findings advocate for a nuanced approach to selecting the reduction method based on fetal position and number, highlighting the need for further research with larger sample sizes.