title: Radiofrequency Ablation with an Internally Cooled Electrode for Twin Reversed Arterial Perfusion Sequence.
abstract: OBJECTIVE
  The study aims to evaluate the efficacy of radiofrequency ablation (RFA) with an internally cooled electrode for twin reversed arterial perfusion (TRAP) sequence.
  
  
  METHODS
  From April 2008 through December 2014, we retrospectively reviewed all patients who underwent RFA with an internally cooled electrode for TRAP sequence at 3 tertiary referral centers in Japan.
  
  
  RESULTS
  Twenty-five monochorionic diamniotic twin pregnancies underwent RFA with an internally cooled electrode for TRAP sequence at 16-27 weeks of gestation. In all cases, umbilical cord blood flow cessation in the acardiac twin was confirmed by ultrasonography with color Doppler. There were 2 cases of procedure-related complications: 1 case of unintentional septostomy and 1 case of anemia in a pump twin. Fetal demise of the pump twin occurred in 3 (12%) cases. Twenty-two (88%) of 25 pump twins were delivered alive. The median gestational age at delivery was 36 + 3 weeks (range 25 + 2-40 + 5 weeks). There were 14 cases (64%) of premature deliveries before 37 weeks and 5 (23%) before 32 weeks.
  
  
  CONCLUSIONS
  RFA with an internally cooled electrode is a feasible and effective procedure for the treatment of TRAP sequence.
authors.affiliation: Division of Perinatology, Fetal Diagnosis and Therapy, Maternal and Perinatal Care Center, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.
authors.forename: Maiko
authors.initials: M
authors.lastname: Wagata
authors.forename: Takeshi
authors.initials: T
authors.lastname: Murakoshi
authors.forename: Keisuke
authors.initials: K
authors.lastname: Ishii
authors.forename: Jin
authors.initials: J
authors.lastname: Muromoto
authors.forename: Jun
authors.initials: J
authors.lastname: Sasahara
authors.forename: Jun
authors.initials: J
authors.lastname: Murotsuki
mesh_terms: D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D004566:Electrodes; D005260:Female; D005330:Fetofetal Transfusion / Q000601:surgery*; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D059285:Pregnancy, Twin; D012189:Retrospective Studies