Xinlu Meng1, Pengbo Yuan1, Lijun Gong1, Xueju Wang1, Tianchen Wu2, Yuan Wei1, Yangyu Zhao1. 1. Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China. 2. Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China.
Abstract
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.
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.