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Radiofrequency ablation for selective reduction in complicated monochorionic multiple pregnancies.

Jing Lu1, Yuen Ha Ting, Kwok Ming Law

  • 1Department of Ultrasound Medicine, Prenatal Diagnosis Center of Xiamen, Maternal and Child Health Hospital, Xiamen, SAR, China.

Fetal Diagnosis and Therapy
|October 26, 2013
PubMed
Summary

Radiofrequency ablation (RFA) offers a promising approach for selective reduction in complicated monochorionic (MC) pregnancies. This technique demonstrated a high co-twin survival rate and a low complication rate in a recent case series.

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Area of Science:

  • Perinatology
  • Maternal-Fetal Medicine
  • Interventional Obstetrics

Background:

  • Monochorionic (MC) multiple pregnancies present unique challenges due to placental sharing.
  • Selective reduction is a therapeutic option for MC pregnancies with specific complications.

Purpose of the Study:

  • To assess the perinatal outcomes of monochorionic multiple pregnancies following selective reduction using radiofrequency ablation (RFA).

Main Methods:

  • A case series review of MC pregnancies undergoing selective reduction via RFA at a single institution.
  • Data collected included indications for reduction, gestational age at procedure and delivery, and survival rates.

Main Results:

  • Ten MC pregnancies (9 twins, 1 triplet) underwent RFA at a median of 15.6 weeks gestation.
  • Indications included fetal anomalies, TRAP sequence, IUGR, and TTTS.
  • The co-twin survival rate was 81.8% (9/11), with a median delivery at 35.9 weeks and a low rate of preterm delivery before 34 weeks.

Conclusions:

  • Radiofrequency ablation (RFA) is a viable and effective technique for selective reduction in complicated MC pregnancies.
  • The procedure is associated with a high survival rate for the co-twin and a low incidence of major complications.