Intracranial injection with KCl: an alternative method in selected cases of multifetal pregnancy reduction.

Multifetal pregnancy reduction (MFPR) offers a therapeutic option which reduces the maternal, prenatal, neonatal morbidity and mortality associated with multifetal pregnancies. In certain cases of MFPR, where difficulty is encountered in reaching the thorax due to the fetal position as well as the location of membranes and placenta, an alternative approach may be the insertion of the needle to the fetal cranium. We describe a new technique for MFPR performed by fetal intracranial injection of potassium chloride. To our knowledge, the current case series is the first report describing the technique of intracranial injection of potassium chloride during MFPR and selective termination. This approach enables a technically easier procedure than the intrathoracic approach. However, the use of this technique should be reserved for selected cases of MFPR only by experienced operators and centers.