ReviewDifferences between selective termination of pregnancy and fetal reduction in multiple pregnancy: a narrative review

Although selective termination of pregnancy and fetal reduction in multiple pregnancy both involve the termination in utero of the development of live fetuses, these two procedures are different in several aspects. Nevertheless, several authors tend to amalgamate and confuse their psychosocial consequences and the ethical issues they raise. Therefore, this narrative review, derived from a comparative analysis of 91 articles, shines a light on these amalgamations and confusions, as well as on the medical, contextual, experiential and ethical differences specific to selective termination and fetal reduction.In the context of multiple pregnancy, when it has been established that one of the fetuses displays signs of a serious disease, pregnant women and their spouses are required to decide if they wish to continue the pregnancy with all the fetuses or to terminate the development of the affected one by a procedure called selective termination of pregnancy. In the same manner, most often encountered with IVF, when it has been established that one or more embryos pose a risk of endangering the continuation of a twin or multiple pregnancy, it is possible to terminate the development of one or more embryos to allow pursuit of the pregnancy with a procedure called fetal reduction of multiple pregnancy. Although both procedures involve in-utero termination of the development of live fetuses or embryos, these two procedures are entirely distinct. Problems occur in scientific literature when authors tend to amalgamate and confuse their psychosocial consequences and the ethical issues raised by each procedure. In this context, we performed a literature review on 91 articles outlining the medical, contextual, experiential and ethical differences specific to selective termination and fetal reduction.