| Bipolar cord coagulation for selective feticide in complicated monochorionic twin pregnancies: 118 consecutive cases at a single center. | |
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MedLine Citation:
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PMID: 22173905 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVES: To review the experience with selective feticide with bipolar cord coagulation (BCC) in complicated monochorionic (MC) twin pregnancies at a single center. METHODS: Retrospective analysis of BCC performed by 3-mm bipolar forceps under ultrasound control in cases complicated by twin-to-twin transfusion syndrome, selective growth restriction, discordant anomaly or twin reverse arterial perfusion sequence. RESULTS: The series comprised 118 cases with a median gestational age at time of procedure of 22 weeks (range 16-30). There were 14 intrauterine deaths of the co-twin (12%), 8 miscarriages (7%), and one termination of pregnancy (1%). When BCC was performed before 19 weeks, the rate of miscarriage was 45%, whereas it was 3% (p < 0.001) after 19 weeks. Preterm prelabor rupture of membranes (PPROM) occurred in 45 cases (38%). The median interval between BCC and PPROM was 5 weeks (interquartile range 2-8). In 15 cases (13%), PPROM occurred within two weeks after the procedure. Median gestational age at delivery was 34 weeks (range 24-41). The median birthweight was 2103 g (range 480-3875). Neonatal death occurred in 11 cases (9%), and 2 children (2%) had severe neurologic morbidity. The overall survival rate was 71% (84/118). CONCLUSION: BCC is an effective procedure in complicated MC twin pregnancies for a selective feticide or when one fetus is severely jeopardized and delivery is not yet an option. Better outcomes can be achieved when this procedure is performed after 19 weeks. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd. |
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Authors:
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Mariano M Lanna; Maria Angela Rustico; Marinella Dell'avanzo; Vito Schena; Stefano Faiola; Dario Consonni; Andrea Righini; Barbara Scelsa; Enrico M Ferrazzi |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-12-15 |
Journal Detail:
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Title: Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology Volume: - ISSN: 1469-0705 ISO Abbreviation: - Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9108340 Medline TA: Ultrasound Obstet Gynecol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd. |
Affiliation:
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Department of Obstetrics and Gynecology, Children's Hospital V. Buzzi, Milan, Italy. marianomatteo.lanna@fastwebnet.it. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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