Combined sonographic and endoscopic umbilical cord occlusion in twin and triplet gestations.
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.
Young
Bruce K
BK
Division of Maternal-Fetal Medicine, New York University School of Medicine, New York 10016, USA. bruce.young@med.nyu.edu
Stephenson
Courtney D
CD
Mackenzie
Andrew P
AP
Roman
Ashley S
AS
Rebarber
Andrei
A
Minior
Victoria K
VK
Mayberry
Patricia
P
Timor-Tritsch
Ilan E
IE
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