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Forty‐five consecutive cases of complicated monochorionic multiple pregnancy treated with microwave ablation: A single‐center experience
Author(s) -
Meng Xinlu,
Yuan Pengbo,
Gong Lijun,
Wang Xueju,
Wu Tianchen,
Wei Yuan,
Zhao Yangyu
Publication year - 2019
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.5423
Subject(s) - medicine , gestational age , microwave ablation , ablation , surgery , monochorionic twins , pregnancy , obstetrics , single center , gestation , fetus , premature rupture of membranes , prospective cohort study , percutaneous , genetics , biology
Objective To describe our preliminary experience in the application of microwave ablation for selective fetal reduction in complicated monochorionic multiple pregnancies. Methods In this prospective study, 45 consecutive complicated monochorionic multiple pregnancies that underwent microwave ablation for selective fetal reduction from July 2015 to February 2017 were analyzed from the first case onward. All patients were managed at the Peking University Third Hospital in Beijing, China. Results There were 45 cases (twins in 40 and triplets in five) treated by microwave ablation. The median gestational age at surgery was 21.3 weeks (range, 15.9‐25.7 wk), with a mean total ablation time of 8.5 ± 4.2 (7.2‐9.7) minutes. There were 12 (26.7%) cases of postprocedural fetal loss. Thirty‐three women delivered alive at a median gestational age of 37.6 weeks (range, 28.6‐40.4 wk). There were no neonatal deaths in our cohort, and the overall survival rate was 73.3% (33/45). Preterm premature rupture of membranes occurred in 9 (20.0%) cases with a median of 7.0 weeks (range, 0.9‐16.3 wk) after the surgery. None of the surviving cotwins had evidence of thermal injury or neurological abnormalities. Conclusion Microwave ablation appears to be a safe and effective method for selective feticide in complicated monochorionic pregnancies.