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Risk factors for fetal death after radiofrequency ablation for complicated monochorionic twin pregnancies
Author(s) -
Sun Luming,
Zou Gang,
Yang Yingjun,
Zhou Fenhe,
Tao Duan
Publication year - 2018
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.5269
Subject(s) - medicine , radiofrequency ablation , fetus , obstetrics , monochorionic twins , twin to twin transfusion syndrome , fetal death , pregnancy , ablation , biology , genetics
Objective Radiofrequency ablation (RFA) is a management alternative for complicated monochorionic twin pregnancies. The purpose of this study is to evaluate risk factors for fetal death after RFA. Methods An observational study was performed to document the perinatal outcomes of all cases undergoing fetal reduction using RFA from 2010 to 2016 at the Shanghai First Maternity and Infant Hospital. A multiple regression model was built to identify predictors of the death of the remaining fetus after RFA. Results A total of 183 patients treated with RFA for fetal reduction were analyzed, including 53 selective intrauterine growth restriction, 35 twin‐twin transfusion syndrome, 36 dichorionic triamniotic triplets, 24 monochorionic twins discordant for fetal anomaly, and 35 twin reversed arterial perfusion. The prevalence of fetal death after RFA was 23% (43:183). The occurrence of fetal death after RFA was independently associated with more than 2 cycles of RFA coagulation (OR 3.46; 95% CI, 1.34‐8.94; P = .01). Conclusion More than 2 cycles of RFA coagulation is the only independent risk factors of fetal death after RFA.