Radiofrequency ablation for selective reduction in the complicated monochorionic gestation.
OBJECTIVE
This study was undertaken to describe the efficacy and safety of radiofrequency ablation for selective reduction in the treatment of complicated monochorionic gestations.


METHODS
Case series of all consecutive patients treated at 1 institution. A 17-gauge radiofrequency needle was inserted under continuous ultrasound guidance into the fetal abdomen at the site of the umbilical cord insertion of the affected twin and radiofrequency energy delivered until cessation of vascular flow was documented with pulsed and color flow Doppler.


RESULTS
Nine patients with monochorionic twin gestations (1 set was part of a triplet gestation) underwent the radiofrequency ablation procedure. Gestational age at the procedure ranged between 18.6-22 weeks. Liveborn infants resulted in two-thirds of cases. Preterm premature rupture of the membranes occurred in 2 of the 9 cases. All liveborn neonates were alive and well.


CONCLUSIONS
Radiofrequency ablation can be effectively used for selective reduction in complicated monochorionic gestations.
Moise
Kenneth J
KJ
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 77030, USA. kjmoise@bcm.edu
Johnson
Anthony
A
Moise
Karen Y
KY
Nickeleit
Volker
V
D000015:Abnormalities, Multiple / Q000453:epidemiology; D017115:Catheter Ablation / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008499:Medical Records; D009657:North Carolina / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D018607:Pregnancy Reduction, Multifetal / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D011262:Pregnancy Trimester, Second; D011272:Pregnancy, Multiple; D011295:Prenatal Care; D016896:Treatment Outcome; D014430:Twins, Monozygotic