Interstitial laser: a new surgical technique for twin reversed arterial perfusion sequence in early pregnancy.
Current treatments for twin reversed arterial perfusion sequence are associated with significant morbidity and most are not feasible in early gestation. We report the use of an interstitial laser in two pregnancies complicated by this sequence at 14 and 15 weeks, respectively. A 600 microm laser fibre was introduced via a 17 gauge needle into the abdomen of the perfused twin close to the vitelline artery and umbilical vein, which were occluded by neodymium:yttrium aluminium garnet (Nd:YAG) laser. Both pregnancies continued uneventfully and each resulted in the birth of a healthy baby at term.
Jolly
M
M
Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, Institute of Reproductive and Developmental Biology, Imperial College School of Medicine, London, UK.
Taylor
M
M
Rose
G
G
Govender
L
L
Fisk
N M
NM
D005260:Female; D005313:Fetal Death; D005330:Fetofetal Transfusion / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D016216:Ultrasonography, Prenatal / Q000379:methods