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Reviews invasive procedures for fetal diagnosis in multiple pregnancies. Role of ultrasonography as a diagnostic tool and therapeutic procedure in multiple gestations; Comparison of singleton and multiple gestations with respect to prenatal genetic diagnosis; Discussion of chorionic villus sampling and amniocentesis; Consideration of multifetal pregnancy reduction; How feticide must be performed; Fetal blood sampling by cordocentesis.

Objective . The objective was to determine the changes in the prenatal detection rate of congenital heart diseases and the emergency neonatal transfer rate due to conducting a fetal cardiac screening using a checklist. Methods . A checklist with 40 items, including eight items regarding the fetal heart, was used by registered medical sonographers conducting ultrasonic screenings on all pregnant women who were scheduled for delivery. Results . The prenatal detection rate of congenital heart diseases was 13.8% prior to the checklist and increased to 34.2% after its implementation. Regarding major congenital heart diseases, the detection rate is now 89.5%, and most diseases can be detected before birth. For five years prior to implementation of fetal cardiac screening, there were 14 cases of newborns (0.14%) requiring emergency neonatal transfer due to a major congenital heart disease that was not detected before birth. For five years after implementation, the emergency transfer rate decreased by 1/7 to 0.02% (two cases). Conclusion . At obstetric facilities where there is no pediatric cardiologist, the number of emergency neonatal transfer cases after birth can be reduced by the following measures: a registered medical sonographer conducts fetal cardiac screening for congenital heart diseases during pregnancy to detect diseases and refer any cases to a perinatal tertiary center in advance. [ABSTRACT FROM AUTHOR]