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Radiofrequency ablation for selective reduction in the complicated monochorionic gestation.

Moise KJ, Johnson A, Moise KY, Nickeleit V

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 77030, USA. kjmoise@bcm.edu

OBJECTIVE: This study was undertaken to describe the efficacy and safety of radiofrequency ablation for selective reduction in the treatment of complicated monochorionic gestations. STUDY DESIGN: 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. CONCLUSION: Radiofrequency ablation can be effectively used for selective reduction in complicated monochorionic gestations.

Published 29 January 2008 in Am J Obstet Gynecol, 198(2): 198.e1-5.
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