Multiple gestations of triplets or more have a significant increase in perinatal morbidity and mortality compared with twins. On average, triplet gestations deliver at approximately 33.5 weeks. Approximately 25% deliver at <32 weeks and 10% deliver <28 weeks. Maternal complications are also significantly increased. Multifetal pregnancy reduction involves the ultrasonically guided injection of KCl into the fetal thorax to induce asystole. It is performed to reduce the potential for early preterm delivery associated with higher-order multiple gestations. Multifetal pregnancy reduction to twins increases gestational age at delivery by 4 weeks and significantly improves maternal and fetal outcomes.