American Journal of Obstetrics & Gynecology
Volume 194, Issue 3 , Pages 782-789, March 2006

Pregnancy and infant outcome of 80 consecutive cord coagulations in complicated monochorionic multiple pregnancies

  • Liesbeth Lewi, MD

      Affiliations

    • UZ-Gasthuisberg, Leuven, Belgium
    • ,
  • Eduardo Gratacos, MD, PhD

      Affiliations

    • Hospital Vall d'Hebron, Barcelona, Spain
    • ,
  • Els Ortibus, MD

      Affiliations

    • UZ-Gasthuisberg, Leuven, Belgium
    • ,
  • Dominique Van Schoubroeck, MD

      Affiliations

    • UZ-Gasthuisberg, Leuven, Belgium
    • ,
  • Elena Carreras, MD

      Affiliations

    • Hospital Vall d'Hebron, Barcelona, Spain
    • ,
  • Teresa Higueras, MD

      Affiliations

    • Hospital Vall d'Hebron, Barcelona, Spain
    • ,
  • Josep Perapoch, MD

      Affiliations

    • Hospital Vall d'Hebron, Barcelona, Spain
    • ,
  • Jan Deprest, MD, PhD

      Affiliations

    • UZ-Gasthuisberg, Leuven, Belgium
    • Corresponding Author InformationReprint requests: Jan Deprest, MD, PhD, Department of Obstetrics and Gynecology, UZ Leuven, B-3000 Leuven, Belgium.

Received 1 May 2005; received in revised form 9 September 2005; accepted 29 September 2005.

Objective

This study was undertaken to document pregnancy and infant outcome after cord coagulation with laser and/or bipolar as a technique for selective feticide in complicated monochorionic multiple pregnancies.

Study design

Prospective follow-up study in 2 tertiary fetal medicine centers.

Results

Eighty cases were included in the study (73 twins, 7 triplets). The survival rate was 83% (72/87). There were 9 intrauterine fetal deaths (10%), 5 within 24 hours and 4 between 4 and 10 weeks after the procedure. There was 1 termination of pregnancy because of chorioamnionitis. Median gestational age at delivery was 35.4 weeks, with 79% of patients delivering after 32 weeks. Preterm prelabor rupture of the membranes before 25 weeks accounted for all perinatal deaths (n = 5). Of the children older than 1 year of age (n = 67), 62 (92%) have a normal development.

Conclusion

Cord coagulation is an effective method for selective feticide in monochorionic multiple pregnancies.

Key words: Cord coagulation, Monochorionic, Multiple pregnancy, Selective feticide

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 Dr Lewi is the recipient of a grant from the 5th Framework Program of the European Commission (no. QLG1-CT-2002-01632 EuroTwin2Twin).Presented in abstract form at the 2003 International Fetal-Maternal Medicine Society Meeting, San Francisco, CA, and the 2003 ISUOG Meeting, Paris, France.

PII: S0002-9378(05)01503-6

doi:10.1016/j.ajog.2005.09.013

American Journal of Obstetrics & Gynecology
Volume 194, Issue 3 , Pages 782-789, March 2006

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