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J Turk Ger Gynecol Assoc. 2018 Oct 9. doi: 10.4274/jtgga.2018.0052. [Epub ahead of print]

Selective fetal reduction in monochorionic twins: Preliminary experience.

Author information

1
Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India.

Abstract

OBJECTIVE:

In complicated mono-chorionic twin pregnancies, vaso-occlusive techniques like bipolar cord coagulation (BPCC), radiofrequency ablation (RFA), interstitial laser ablation (ILA) of cord and fetoscopy guided cord coagulation with lasers are the methods proposed for selective fetal reduction. This study brings forth preliminary data of selective fetal reduction procedures at a tertiary care center in India.

MATERIAL AND METHODS:

This was a prospective observational study of 31 patients with complicated mono-chorionic twin pregnancies. Methods used were ILA, RFA and BPCC. Outcome measures included overall co-twin survival after selective feticide, survival rates with each method, miscarriage (defined as all fetal loss before 24 weeks), early fetal death (<24 hours after procedure) and late fetal death (>24hrs after the procedure) of co-twin.

RESULTS:

Technical success was achieved in 30/31(96.8%) of pregnancies. Over all take home baby rate was 63.3%. Live birth rates were 50%, 71.4% and 75%with ILA, RFA and BPCC respectively.

CONCLUSION:

Data from initial cases of selective fetal reduction in complicated mono-chorionic twins suggests that these procedures are feasible but are associated with high adverse perinatal outcome.

KEYWORDS:

Bipolar cord coagulation; Interstitial Laser Radiofrequency ablation.; Monochorionic; Selective fetal reduction

PMID:
30299263
DOI:
10.4274/jtgga.2018.0052
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