title: Disentanglement of Discordant Monochorionic-Monoamniotic Twins in a Triplet Pregnancy: An Innovative Approach Utilizing Fetoscopic Laser Coagulation with Micro-Laparoscopic Scissor Dissection.
abstract: Triplet gestations are associated with high perinatal morbidity. Dichorionic-diamniotic triplet pregnancies with growth discordance, polyhydramnios and structural anomalies carry a significantly increased risk of fetal morbidity and mortality from the baseline risks of high-order multiple pregnancies. Intrauterine fetal death of one fetus of a monochorionic pregnancy may cause neurological injury to the surviving fetus. We present a case where an innovative technique was created combining use of the fetoscopic laser and miniature laparoscopic instruments to selectively reduce and disentangle the umbilical cord of the acranial growth-restricted fetus from the structurally normal fetus's umbilical cord in a dichorionic-diamniotic triplet pregnancy.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Winthrop University Hospital, Mineola, N.Y., USA.
authors.forename: Nadia B
authors.initials: NB
authors.lastname: Kunzier
authors.forename: Baraa
authors.initials: B
authors.lastname: Allaf
authors.forename: Martin R
authors.initials: MR
authors.lastname: Chavez
authors.forename: Diana
authors.initials: D
authors.lastname: Abenanti-Richmond
authors.forename: Anthony M
authors.initials: AM
authors.lastname: Vintzileos
mesh_terms: D000328:Adult; D005260:Female; D005317:Fetal Growth Retardation / Q000601:surgery*; D005332:Fetoscopy / Q000379:methods*; D005865:Gestational Age; D006801:Humans; D017075:Laser Coagulation; D011247:Pregnancy; D011256:Pregnancy Outcome; D018607:Pregnancy Reduction, Multifetal / Q000379:methods*; D059286:Pregnancy, Triplet; D014470:Umbilical Cord / Q000000981:diagnostic imaging / Q000601:surgery*