Perinatology.  2020 Sep;31(3):145-150. 10.14734/PN.2020.31.3.145.

Intrafetal Laser Treatment for Selective Feticide in Monochorionic Multiple Pregnancies

Affiliations
  • 1Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
  • 2The Institute of Reproductive Medicine and Population, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea

Abstract

Intrafetal coagulation by a radiofrequency ablation (RFA) device has traditionally been used for selec tive feticide in complicated monochorionic multiple pregnancies. However, as RFA is not feasible in early pregnancy, intrafetal laser coagulation has recently been suggested as an alternative method in the early mid-trimester period. This study aimed to report our experience of utilizing intrafetal laser coagulation for selective feticide in early complicated monochorionic multiple pregnancies. Three monochorionic multiple pregnancies that were treated with intrafetal laser coagulation before 20 weeks were described. Sonographic findings during pregnancy, antepartum course, and intrafetal laser coagulation procedure were reviewed, along with their perinatal outcomes. Indications were twin reversed arterial perfusion sequence in two cases, and dichorionic tri-amniotic triplets compli­cated with twin-to-twin transfusion syndrome in one case. Intrafetal laser coagulation was successful in all three cases, with favorable neonatal outcomes.

Keyword

Multiple pregnancy; Complication; Fetoscopic surgical procedure; Laser ablation
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