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Transabdominal selective feticide in dichorionic twins: Ten years’ experience at a single center
Author(s) -
Kim Mi Sun,
Na Eun Duc,
Kang Sukho,
Shin So Yeon,
Lim Bo Bae,
Kim Hounyoung,
Moon Myoung Jin
Publication year - 2019
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13830
Subject(s) - medicine , obstetrics , pregnancy , twin pregnancy , gestational age , single center , fetus , live birth , surgery , genetics , biology
Aim The present study investigates the procedure‐related fetal loss rate and obstetrical outcomes of selective feticide in dichorionic twins. Methods We retrospectively analyzed the data of 44 cases of dichorionic twins. Two different indications for selective feticide were set: (i) the presence of genetic or congenital anomaly; and (ii) an obstetrical indication specified as a past maternal history of preterm delivery that caused fetal death or cerebral palsy of the child. Primarily, data on procedure‐related fetal loss and obstetrical outcomes were retrieved. Additionally, data on obstetrical outcomes by reduction time and by indication of SF were obtained. Results Selective feticide was performed in 44 cases – specifically, in 23 cases with genetic or congenital anomaly and in 21 cases with obstetrical indications. The median gestational age at delivery was 38 + 4 weeks. One pregnancy loss (2.3%, 1/44) occurred within 4 weeks after the procedure. The overall pregnancy loss rate throughout the pregnancy term was 2.3% (1/44). When selective feticide was performed at 15 weeks and beyond, the birth weight was significantly decreased compared with when selective feticide was performed earlier than 15 weeks. Conclusion Transabdominal ultrasound‐guided selective feticide in dichorionic twins is an effective and safe procedure. If a patient desires to maximize her chances of having a healthy child and decrease the risk of prematurity, the option of selective feticide should be considered in certain cases of twin pregnancies. Selective feticide may be a reasonable alternative to expectant management or termination of the whole twin pregnancy.