title: Combined sonographic and endoscopic umbilical cord occlusion in twin and triplet gestations.
abstract: OBJECTIVE
  To review our experience with a minimally invasive technique for umbilical cord occlusion as a method of selective feticide in monochorionic sets.
  
  
  METHODS
  Umbilical cord occlusion was completed using 3 mm bipolar cautery under ultrasound guidance (3D/4D, n = 6; 2D, n = 6) with pre and post ligation endoscopic evaluation.
  
  
  RESULTS
  12 cases of monochorionic sets where selective feticide was performed were identified during the period 2000 to present. There were four triplet and eight twin gestations in the study cohort. Median interval from intervention to delivery was 16 weeks (range, 5-19). All co-twins survived the procedure and 15 of 16 were delivered after 33 weeks.
  
  
  CONCLUSIONS
  Umbilical cord occlusion in monochorionic sets can be accomplished in a minimally invasive manner with combined endoscopic and ultrasound guidance in both twin and triplet pregnancies.
authors.affiliation: Division of Maternal-Fetal Medicine, New York University School of Medicine, New York 10016, USA. bruce.young@med.nyu.edu
authors.forename: Bruce K
authors.initials: BK
authors.lastname: Young
authors.forename: Courtney D
authors.initials: CD
authors.lastname: Stephenson
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Mackenzie
authors.forename: Ashley S
authors.initials: AS
authors.lastname: Roman
authors.forename: Andrei
authors.initials: A
authors.lastname: Rebarber
authors.forename: Victoria K
authors.initials: VK
authors.lastname: Minior
authors.forename: Patricia
authors.initials: P
authors.lastname: Mayberry
authors.forename: Ilan E
authors.initials: IE
authors.lastname: Timor-Tritsch
mesh_terms: D003250:Constriction; D005260:Female; D005330:Fetofetal Transfusion / Q000000981:diagnostic imaging / Q000601:surgery; D005332:Fetoscopy / Q000379:methods; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome; D018607:Pregnancy Reduction, Multifetal / Q000379:methods*; D011272:Pregnancy, Multiple; D014310:Triplets; D014430:Twins, Monozygotic; D016216:Ultrasonography, Prenatal / Q000379:methods; D014470:Umbilical Cord