Will the fetus be expelled after selective reduction?

Nov 11, 2025 Source: Cainiu Health

Dr. Zhang Lu

Introduction

If the pregnancy is at an early gestational age (e.g., in the first trimester) when fetal reduction is performed, doctors often use medications to induce uterine contractions or perform minimally invasive procedures to stop the development of the targeted fetus. The body will then initiate a natural expulsion process, and the non-viable fetus will gradually be expelled through vaginal bleeding or contractions, similar to an early miscarriage. After expulsion, it is important to monitor for any retained tissue.

Generally, after selective fetal reduction, if medication or minimally invasive methods are used and the gestational age is small, the fetus is usually naturally expelled along with uterine contractions. However, if the gestational age is larger or the reduced fetus is absorbed in utero, it may not be completely expelled. If you have any concerns, it is recommended to consult a healthcare provider in advance. Detailed explanations are as follows:

If the gestational age is small at the time of reduction (e.g., early pregnancy), doctors typically use medications to induce uterine contractions or perform minimally invasive procedures to stop the targeted fetus's development. The body then initiates a natural expulsion process, during which the nonviable fetus is gradually expelled through vaginal bleeding or contractions, similar to an early miscarriage. After expulsion, it is important to monitor for any retained tissue.

If the gestational age is more advanced (e.g., mid-pregnancy) or if the reduction method focuses on stopping fetal development in utero and allowing maternal absorption (such as by interrupting the fetal blood supply), the nonviable fetus may not be fully expelled. Instead, it is gradually absorbed by the mother’s body. In only a few cases might some residual tissue be expelled later during routine prenatal checkups or delivery. In such situations, ultrasound monitoring is required to confirm the absorption process.

After fetal reduction, closely monitor symptoms such as vaginal bleeding and abdominal pain. Follow your doctor’s instructions for regular follow-up ultrasounds and hormone level testing to assess the development of the remaining fetus(es) and the progress of expulsion or absorption. Seek immediate medical attention if any abnormal symptoms occur; avoid self-management to prevent adverse health effects.

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