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Selective fetal reduction in monochorionic twins: Preliminary experience

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...

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Autores principales: Dadhwal, Vatsla, Sharma, Aparna K., Deka, Dipika, Chawla, Latika, Agarwal, Nutan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Galenos Publishing 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6558353/
https://www.ncbi.nlm.nih.gov/pubmed/30299263
http://dx.doi.org/10.4274/jtgga.galenos.2018.2018.0052
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author Dadhwal, Vatsla
Sharma, Aparna K.
Deka, Dipika
Chawla, Latika
Agarwal, Nutan
author_facet Dadhwal, Vatsla
Sharma, Aparna K.
Deka, Dipika
Chawla, Latika
Agarwal, Nutan
author_sort Dadhwal, Vatsla
collection PubMed
description 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 (>24 hours 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.
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spelling pubmed-65583532019-06-19 Selective fetal reduction in monochorionic twins: Preliminary experience Dadhwal, Vatsla Sharma, Aparna K. Deka, Dipika Chawla, Latika Agarwal, Nutan J Turk Ger Gynecol Assoc Original Investigation 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 (>24 hours 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. Galenos Publishing 2019-06 2019-05-28 /pmc/articles/PMC6558353/ /pubmed/30299263 http://dx.doi.org/10.4274/jtgga.galenos.2018.2018.0052 Text en © Copyright 2019 by the Turkish-German Gynecological Education and Research Foundation http://creativecommons.org/licenses/by/2.5/ Journal of the Turkish-German Gynecological Association published by Galenos Publishing House.
spellingShingle Original Investigation
Dadhwal, Vatsla
Sharma, Aparna K.
Deka, Dipika
Chawla, Latika
Agarwal, Nutan
Selective fetal reduction in monochorionic twins: Preliminary experience
title Selective fetal reduction in monochorionic twins: Preliminary experience
title_full Selective fetal reduction in monochorionic twins: Preliminary experience
title_fullStr Selective fetal reduction in monochorionic twins: Preliminary experience
title_full_unstemmed Selective fetal reduction in monochorionic twins: Preliminary experience
title_short Selective fetal reduction in monochorionic twins: Preliminary experience
title_sort selective fetal reduction in monochorionic twins: preliminary experience
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6558353/
https://www.ncbi.nlm.nih.gov/pubmed/30299263
http://dx.doi.org/10.4274/jtgga.galenos.2018.2018.0052
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