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Experience with fetoscopic cord ligation

J A Deprest1, P P Van Ballaer, V A Evrard

  • 1Department of Obstetrics and Gynaecology, University Hospital Gasthuisberg, Leuven, Belgium. Jan.Deprest@uz.kuleuven.ac.be

European Journal of Obstetrics, Gynecology, and Reproductive Biology
|February 16, 1999
PubMed
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Fetoscopic cord ligation is a feasible procedure for monochorionic pregnancies with one non-viable fetus. This technique offers a 71% survival rate for the co-twin but carries a high risk of preterm prelabour rupture of membranes (PPROM).

Area of Science:

  • Maternal-Fetal Medicine
  • Surgical Innovation
  • Perinatal Outcomes

Background:

  • Monochorionic multiple pregnancies with a non-viable fetus pose risks to the surviving twin.
  • Fetoscopic laser ablation is a common treatment, but cord ligation offers an alternative.
  • Limited data exists on the efficacy and risks of fetoscopic cord ligation.

Observation:

  • A descriptive case series of four patients undergoing fetoscopic cord ligation was reviewed.
  • A literature review of cases published up to 1996 was conducted.
  • The combined series included 23 cases of fetoscopic cord ligation.

Findings:

  • Fetoscopic cord ligation was successful in 21 out of 23 cases (91%).
  • The overall survival rate for the co-twin was 71% (17 out of 23 live births).

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  • Preterm prelabour rupture of membranes (PPROM) occurred in approximately 40% of cases, often before 32 weeks gestation.

    • Implications:

    • Fetoscopic cord ligation is a viable option for selected monochorionic pregnancies.
    • Close monitoring for PPROM is crucial following the procedure.
    • Further research is needed to optimize technique and manage PPROM risks.