Maternal outcome of selective feticide due to fetal anomaly in late trimester: A retrospective 10 years’ experience in Taiwan

Sep 29, 2026

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Retrospective evaluation of maternal and fetal outcomes in twin pregnancies complicated by fetal anomalies, focusing on selective feticide performance in late gestational timing. From 2009–2018, 68 pregnancies received feticide via intracardiac potassium chloride injection to induce fetal asystole, with dichorionic twin characteristics compared before versus after 24 weeks. Results showed feticide was delivered without maternal or fetal complications, and earlier selective feticide achieved a higher mean gestational age at delivery, supporting clinical safety when preceded by sufficient discussion.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages4

Reading Time10 min

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Introduction

Methods

Participants

Results

Conclusion

J Chin MedAssoc Original article Maternal outcome of selective feticide due to fetal anomaly in late trimester: A retrospective 10 years’ experience in Taiwan Chen-Ai Sunga,b, Tzu-Yi Lina, Han-Ni Leea, Kok-Seong Chanb, Tai-Ho Hunga,b, Steven W. Shawa,b,c,* aCollege of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC; bDepartment of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan, ROC; cPrenatal Cell and Gene Therapy Group, Institute for Women’s Health University College London, London, United Kingdom Abstract Background: Feticide was suggested to avoid delivering children with abnormalities. Recently, twin pregnancies have increased. Selective feticide was proposed to achieve a good outcome of pregnancy. This study aimed to evaluate the performance of feticide in twin pregnancy with fetal anomaly. Methods: This was a retrospective study enrolled from 2009 to 2018. A total of 68 pregnancies with fetal anomalies received feticide. Potassium chloride was injected into the left ventricle to induce fetal asystole. Maternal and fetal characteristics of 16 dichorionic twins were documented to compare before and after 24th gestational week. Results: All pregnant women received feticide without any maternal or fetal complication. The reasons for choosing feticide were divided into four groups, including morphologic defect (61 .8%), genetic-chromosomal abnormality (30 .9%), obstetrical complication (5 .9%), and maternal request (1 .5%) . Mean gestational age at delivery was significantly higher in dichorionic twins who underwent selective feticide before than after 24th gestational week (36 .7 vs 33.4, p = 0.04) . Conclusion: Intracardiac injection of potassium chloride was effective for feticide and safe for mothers and fetuses. Selective feticide served as an alternative approach for twin pregnancy with fetal anomaly after sufficient discussion. Keywords: Dichorionic twin; Feticide; Fetal anomaly; Late trimester; Potassium chloride 1. INTRODUCTION The gradual evolution of high-resolution ultrasound sonography (US) and prenatal diagnostic technique has assisted in the early diagnosis of fetal abnormality. However, certain diseases are lately identified in the second or third trimester. Induced feticide is necessary for avoiding the termination of pregnancy with a viable fetus.1 Feticide refers to causing the death of a fetus, which is generally conducted prior to mid-to late-second trimester of pregnancy. Parents could opt for feticide before termination of pregnancy to relieve themselves of the unwarranted legal, financial or emotional burden. In recent years, the number of twin pregnancies has increased gradually, and more complications have been observed in mothers and fetuses.2 Twin pregnancy achieved a higher rate of chromosomal or structural abnormality than a singleton pregnancy.3 Therefore, selective feticide is considered a way to avoid giving *Address correspondence. Dr. Steven W. Shaw, Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, 199, Dun-Hua North Road, Taipei 105, Taiwan, [ROC. E-mail: dr.shaw@me.com](ROC. E-mail: dr.shaw@me.com). (S. W. Shaw) Conflicts of interest: The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article. Journal of Chinese Medical Association. (2022) 85: 212-215. Received April 29, 2021; accepted June 14, 2021. doi: 10. 1097/JCMA.0000000000000610. Copyright © 2021, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/](http://creativecommons.org/licenses/)[ ](http://creativecommons.org/licenses/)[by-nc-nd/4.0/](by-nc-nd/4.0/)) birth to a viable fetus with severe disease.4 In this article, we assessed several cases of late termination of pregnancy in a tertiary medical center in Taiwan. Maternal and fetal outcomes of surgery were documented to evalua

FAQs

What was the purpose of the study on selective feticide?

The study aimed to evaluate how selective feticide performs in twin pregnancies with fetal anomalies and to assess maternal and fetal outcomes.

How was feticide performed in the study?

Potassium chloride was injected into the left ventricle to induce fetal asystole, and maternal and fetal characteristics were documented for comparison around 24 gestational weeks.

What were the main safety findings for mothers and fetuses?

All pregnant women received feticide without any maternal or fetal complication, and potassium chloride intracardiac injection was concluded to be effective and safe.

Sep 29, 2026

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