Pregnancy and infant outcome of 80 consecutive cord coagulations in complicated monochorionic multiple pregnancies.
OBJECTIVE
This study was undertaken to document pregnancy and infant outcome after cord coagulation with laser and/or bipolar as a technique for selective feticide in complicated monochorionic multiple pregnancies.


METHODS
Prospective follow-up study in 2 tertiary fetal medicine centers.


RESULTS
Eighty cases were included in the study (73 twins, 7 triplets). The survival rate was 83% (72/87). There were 9 intrauterine fetal deaths (10%), 5 within 24 hours and 4 between 4 and 10 weeks after the procedure. There was 1 termination of pregnancy because of chorioamnionitis. Median gestational age at delivery was 35.4 weeks, with 79% of patients delivering after 32 weeks. Preterm prelabor rupture of the membranes before 25 weeks accounted for all perinatal deaths (n = 5). Of the children older than 1 year of age (n = 67), 62 (92%) have a normal development.


CONCLUSIONS
Cord coagulation is an effective method for selective feticide in monochorionic multiple pregnancies.
Lewi
Liesbeth
L
UZ-Gasthuisberg, Leuven, Belgium.
Gratacos
Eduardo
E
Ortibus
Els
E
Van Schoubroeck
Dominique
D
Carreras
Elena
E
Higueras
Teresa
T
Perapoch
Josep
J
Deprest
Jan
J
D002648:Child; D002675:Child, Preschool; D002823:Chorion; D004564:Electrocoagulation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology; D017075:Laser Coagulation; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000601:surgery*; D011256:Pregnancy Outcome; D018607:Pregnancy Reduction, Multifetal / Q000379:methods*; D011272:Pregnancy, Multiple; D011446:Prospective Studies; D015996:Survival Rate; D014310:Triplets; D014427:Twins; D014470:Umbilical Cord / Q000601:surgery*