Selective fetal termination in monochorionic twin pregnancies - pregnancy outcome after bipolar cord coagulation and interstitial laser coagulation
Introduction/Objective. In this paper we present the perinatal outcome after selective fetal termination (SFT) in monochorionic (MH) twins done by bipolar cord coagulation (BCC) and interstitial laser coagulation (ILC). Methods. During a five-year period, SFT was done in 22 MH twins. BCC was done in...
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| Format: | Article |
| Language: | English |
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Serbian Medical Society
2020-01-01
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| Series: | Srpski Arhiv za Celokupno Lekarstvo |
| Subjects: | |
| Online Access: | http://www.doiserbia.nb.rs/img/doi/0370-8179/2020/0370-81791900125M.pdf |
| _version_ | 1818325405611851776 |
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| author | Mandić-Marković Vesna Miković Željko Filimonović Dejan |
| author_facet | Mandić-Marković Vesna Miković Željko Filimonović Dejan |
| author_sort | Mandić-Marković Vesna |
| collection | DOAJ |
| description | Introduction/Objective. In this paper we present the perinatal outcome after selective fetal termination (SFT) in monochorionic (MH) twins done by bipolar cord coagulation (BCC) and interstitial laser coagulation (ILC). Methods. During a five-year period, SFT was done in 22 MH twins. BCC was done in 15 and ILC in seven cases. We registered the indication for SFT, gestational age at SFT, immediate postoperative death and late death of the co-twin, PPROM (preterm pre-labor rupture of membranes), gestational age at delivery/abortion, procedure-to-delivery interval, mode of delivery, neonatal body weight and 5-minute Apgar score. Results. Live birth was significantly higher after BCC than after ILC (86.7:57.1%). Gestational age at intervention was higher in BCC (20.2 ± 1.8 : 16.5 ± 1.7 weeks). Gestational age at delivery/abortion was lower for ILC (32.5 ± 4.8 : 27.5 ± 9.5 weeks); however, there was no difference when comparing live births only (33.8 ± 3.7 : 34.7 ± 4.5 weeks). There was no difference between procedure-to-delivery/abortion interval (86.7 ± 33.7 : 77.1 ± 73 days); however, the interval was significantly higher after ILC when comparing live births only (93.3 ± 33 : 133 ± 30.9 days). There was no difference in PPROM (26.7:14.3%); preterm delivery (69.2:50%); Cesarean section rate (84.6:75%); neonatal body weight (2174 ± 82.4 : 2475 ± 823 g); or Apgar score (7.7 ± 1.9 : 9.2 ± 1). Conclusion. There is no ideal method of SFT in MH twins. Success of each SFT method depends upon the correctly set indication, gestational age at the procedure, and the SFT technique. The risk of co-twin death is lower after BCC than after ILC. As in Narodni Front University Clinic for Gynecology and Obstetrics better results were achieved after BCC, this method became a standard for SFT in MH twins, except in cases of twin reversed arterial perfusion sequence before 16 weeks. |
| first_indexed | 2024-12-13T11:43:58Z |
| format | Article |
| id | doaj.art-f2a6ff66be994940a94cba02102dac6a |
| institution | Directory Open Access Journal |
| issn | 0370-8179 |
| language | English |
| last_indexed | 2024-12-13T11:43:58Z |
| publishDate | 2020-01-01 |
| publisher | Serbian Medical Society |
| record_format | Article |
| series | Srpski Arhiv za Celokupno Lekarstvo |
| spelling | doaj.art-f2a6ff66be994940a94cba02102dac6a2022-12-21T23:47:35ZengSerbian Medical SocietySrpski Arhiv za Celokupno Lekarstvo0370-81792020-01-011481-2646910.2298/SARH180806125M0370-81791900125MSelective fetal termination in monochorionic twin pregnancies - pregnancy outcome after bipolar cord coagulation and interstitial laser coagulationMandić-Marković Vesna0Miković Željko1Filimonović Dejan2University of Belgrade, Faculty of Medicine, Belgrade, Serbia + University Clinic for Gynecology and Obstetrics Narodni Front, Belgrade, SerbiaUniversity of Belgrade, Faculty of Medicine, Belgrade, Serbia + University Clinic for Gynecology and Obstetrics Narodni Front, Belgrade, SerbiaUniversity of Belgrade, Faculty of Medicine, Belgrade, Serbia + University Clinic for Gynecology and Obstetrics Narodni Front, Belgrade, SerbiaIntroduction/Objective. In this paper we present the perinatal outcome after selective fetal termination (SFT) in monochorionic (MH) twins done by bipolar cord coagulation (BCC) and interstitial laser coagulation (ILC). Methods. During a five-year period, SFT was done in 22 MH twins. BCC was done in 15 and ILC in seven cases. We registered the indication for SFT, gestational age at SFT, immediate postoperative death and late death of the co-twin, PPROM (preterm pre-labor rupture of membranes), gestational age at delivery/abortion, procedure-to-delivery interval, mode of delivery, neonatal body weight and 5-minute Apgar score. Results. Live birth was significantly higher after BCC than after ILC (86.7:57.1%). Gestational age at intervention was higher in BCC (20.2 ± 1.8 : 16.5 ± 1.7 weeks). Gestational age at delivery/abortion was lower for ILC (32.5 ± 4.8 : 27.5 ± 9.5 weeks); however, there was no difference when comparing live births only (33.8 ± 3.7 : 34.7 ± 4.5 weeks). There was no difference between procedure-to-delivery/abortion interval (86.7 ± 33.7 : 77.1 ± 73 days); however, the interval was significantly higher after ILC when comparing live births only (93.3 ± 33 : 133 ± 30.9 days). There was no difference in PPROM (26.7:14.3%); preterm delivery (69.2:50%); Cesarean section rate (84.6:75%); neonatal body weight (2174 ± 82.4 : 2475 ± 823 g); or Apgar score (7.7 ± 1.9 : 9.2 ± 1). Conclusion. There is no ideal method of SFT in MH twins. Success of each SFT method depends upon the correctly set indication, gestational age at the procedure, and the SFT technique. The risk of co-twin death is lower after BCC than after ILC. As in Narodni Front University Clinic for Gynecology and Obstetrics better results were achieved after BCC, this method became a standard for SFT in MH twins, except in cases of twin reversed arterial perfusion sequence before 16 weeks.http://www.doiserbia.nb.rs/img/doi/0370-8179/2020/0370-81791900125M.pdfselective fetal terminationmonochorionic twinsbipolar cord coagulationinterstitial laser coagulation |
| spellingShingle | Mandić-Marković Vesna Miković Željko Filimonović Dejan Selective fetal termination in monochorionic twin pregnancies - pregnancy outcome after bipolar cord coagulation and interstitial laser coagulation Srpski Arhiv za Celokupno Lekarstvo selective fetal termination monochorionic twins bipolar cord coagulation interstitial laser coagulation |
| title | Selective fetal termination in monochorionic twin pregnancies - pregnancy outcome after bipolar cord coagulation and interstitial laser coagulation |
| title_full | Selective fetal termination in monochorionic twin pregnancies - pregnancy outcome after bipolar cord coagulation and interstitial laser coagulation |
| title_fullStr | Selective fetal termination in monochorionic twin pregnancies - pregnancy outcome after bipolar cord coagulation and interstitial laser coagulation |
| title_full_unstemmed | Selective fetal termination in monochorionic twin pregnancies - pregnancy outcome after bipolar cord coagulation and interstitial laser coagulation |
| title_short | Selective fetal termination in monochorionic twin pregnancies - pregnancy outcome after bipolar cord coagulation and interstitial laser coagulation |
| title_sort | selective fetal termination in monochorionic twin pregnancies pregnancy outcome after bipolar cord coagulation and interstitial laser coagulation |
| topic | selective fetal termination monochorionic twins bipolar cord coagulation interstitial laser coagulation |
| url | http://www.doiserbia.nb.rs/img/doi/0370-8179/2020/0370-81791900125M.pdf |
| work_keys_str_mv | AT mandicmarkovicvesna selectivefetalterminationinmonochorionictwinpregnanciespregnancyoutcomeafterbipolarcordcoagulationandinterstitiallasercoagulation AT mikoviczeljko selectivefetalterminationinmonochorionictwinpregnanciespregnancyoutcomeafterbipolarcordcoagulationandinterstitiallasercoagulation AT filimonovicdejan selectivefetalterminationinmonochorionictwinpregnanciespregnancyoutcomeafterbipolarcordcoagulationandinterstitiallasercoagulation |