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Published on: September 5, 2011
Radiofrequency ablation for selective reduction in the complicated monochorionic gestation
Kenneth J Moise1, Anthony Johnson, Karen Y Moise
1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 77030, USA. kjmoise@bcm.edu
American Journal of Obstetrics and Gynecology
|January 30, 2008
Summary
Radiofrequency ablation is an effective treatment for complicated monochorionic gestations, leading to liveborn infants in most cases. This procedure offers a safe option for selective reduction in high-risk twin pregnancies.
Area of Science:
- Maternal-Fetal Medicine
- Interventional Obstetrics
- Reproductive Medicine
Background:
- Monochorionic gestations present complex challenges, including selective fetal reduction.
- Complicated monochorionic pregnancies require effective and safe interventions.
Purpose of the Study:
- To evaluate the efficacy and safety of radiofrequency ablation (RFA) for selective reduction in complicated monochorionic gestations.
Main Methods:
- A case series of consecutive patients undergoing RFA for selective reduction.
- Ultrasound-guided insertion of a 17-gauge radiofrequency needle into the umbilical cord insertion site.
- Delivery of radiofrequency energy to achieve cessation of vascular flow, confirmed by Doppler ultrasound.
Main Results:
- Nine patients with complicated monochorionic gestations underwent RFA.
- The procedure was performed between 18.6 and 22 weeks of gestation.
- Two-thirds of cases resulted in liveborn infants, all of whom were healthy; 2 cases experienced preterm premature rupture of membranes.
Conclusions:
- Radiofrequency ablation is a viable and effective method for selective reduction in complicated monochorionic gestations.
- The procedure demonstrates a favorable safety profile with positive outcomes for liveborn neonates.
