title: Experience with fetoscopic cord ligation.
abstract: OBJECTIVE
  In the case of a monochorionic multiple pregnancy with one non-viable fetus who compromises its co-twin, fetoscopic cord ligation may be performed. We describe our fetoscopic cord ligation technique and discuss the efficacy of cord ligation for salvaging the co-twin, based on available data.
  
  
  METHODS
  Descriptive case series of four cases and review of the cases published up to 1996.
  
  
  RESULTS
  We performed four successful ligations. Of the 23 reported cases, which include the present series, two ligations failed. Four fetuses died in utero, and 17 were born alive at a mean of 8 weeks following the procedure. Two babies died in the perinatal period, a third after 60 days. Preterm uterine contractions do not seem to be a clinical problem. Preterm prelabour rupture of the membranes (PPROM) complicates about 40% of cases, the majority occurring prior to 32 weeks.
  
  
  CONCLUSIONS
  Fetoscopic cord ligation is a feasible procedure with a 71% survival rate and a high risk for PPROM.
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital Gasthuisberg, Leuven, Belgium. Jan.Deprest@uz.kuleuven.ac.be
authors.forename: J A
authors.initials: JA
authors.lastname: Deprest
authors.forename: P P
authors.initials: PP
authors.lastname: Van Ballaer
authors.forename: V A
authors.initials: VA
authors.lastname: Evrard
authors.forename: K H
authors.initials: KH
authors.lastname: Peers
authors.forename: B
authors.initials: B
authors.lastname: Spitz
authors.forename: E A
authors.initials: EA
authors.lastname: Steegers
authors.forename: K
authors.initials: K
authors.lastname: Vandenberghe
mesh_terms: D000328:Adult; D005260:Female; D005330:Fetofetal Transfusion / Q000601:surgery*; D005332:Fetoscopy; D006801:Humans; D008026:Ligation; D011247:Pregnancy; D014470:Umbilical Cord