| Radiofrequency ablation for selective reduction in complex monochorionic pregnancies. | |
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MedLine Citation:
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PMID: 20722644 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Monochorionic pregnancies present unique challenges for selective fetal reduction, as vaso-occlusive procedures are required to ablate blood flow, usually in the umbilical cord, to achieve asystole in the selected fetus. We describe a case series of 35 monochorionic pregnancies (27 twins and eight triplets) undergoing selective fetal reduction using radiofrequency ablation. All procedures were performed under local anaesthesia. The procedure was technically successful in all cases. The live born rate was 88.6%. One (2.9%) woman miscarried within 2 weeks of the procedure, and two (5.7%) babies were stillborn. The median gestation at delivery was 36 weeks of gestation (range 24-41 weeks). There were no maternal complications. The median gestational age at procedure was 17 + 3 weeks (range from 12 + 5 to 27 + 4 weeks). All women had antenatal magnetic resonance imaging (MRI) post procedure. There were two (5.7%) cases of abnormal brain imaging. Our experience suggests that radiofrequency ablation is a safe and effective procedure for fetal reduction in complicated monochorionic pregnancies. |
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Authors:
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G Paramasivam; R Wimalasundera; M Wiechec; E Zhang; F Saeed; S Kumar |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: BJOG : an international journal of obstetrics and gynaecology Volume: 117 ISSN: 1471-0528 ISO Abbreviation: BJOG Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-20 Completed Date: 2010-11-08 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100935741 Medline TA: BJOG Country: England |
Other Details:
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Languages: eng Pagination: 1294-8 Citation Subset: AIM; IM |
Affiliation:
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Centre for Fetal and Maternal Medicine, Queen Charlottes and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Catheter Ablation / adverse effects, methods* Cesarean Section / statistics & numerical data Female Fetal Diseases / surgery Fetal Membranes, Premature Rupture / etiology Fetus / abnormalities Gestational Age Humans Pregnancy Pregnancy Outcome Pregnancy Reduction, Multifetal / methods* Pregnancy, Multiple* Prenatal Care / methods Triplets Twins, Monozygotic Young Adult |
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