Perinatal- and procedure-related outcomes following radiofrequency ablation in monochorionic pregnancy

Sailesh Kumar, Gowrishankar Paramasivam, Eko Zhang, Bryony Jones, Muna Noori, Tomas Prior, Akhila Vasudeva, Ruwan C. Wimalasundera

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Objective We sought to assess the efficacy, complication rates, and outcomes for complex monochorionic pregnancies undergoing selective fetal reduction using radiofrequency ablation (RFA). Study Design In this prospective observational study, 100 consecutive cases of selective fetal reduction using RFA were analyzed. All cases were managed at the Centre for Fetal Care at Queen Charlotte's and Chelsea Hospital in London. Indications for offering RFA, details of the procedure, and pregnancy outcomes were collected and analyzed. Results The main indications for RFA were discordant fetal anomaly and twin-twin transfusion syndrome. Overall live birth rate was 78% and the median gestation at delivery was 35.15 weeks. Delivery <32 weeks' gestation occurred in 17.9% of cases. Postprocedure abnormal antenatal magnetic resonance imaging occurred in 3% of cases. There was no statistical difference in outcomes with regard to gestation when the procedure was performed or the indication for the RFA. Conclusion RFA appears to be a reasonable option for selective fetal reduction in complex monochorionic pregnancies with an overall survival rate of 78%.

Original languageEnglish
JournalAmerican Journal of Obstetrics and Gynecology
Volume210
Issue number5
DOIs
Publication statusPublished - 01-01-2014

Fingerprint

Multifetal Pregnancy Reduction
Pregnancy
Fetofetal Transfusion
Birth Rate
Live Birth
Pregnancy Outcome
Observational Studies
Survival Rate
Magnetic Resonance Imaging
Prospective Studies

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynaecology

Cite this

Kumar, Sailesh ; Paramasivam, Gowrishankar ; Zhang, Eko ; Jones, Bryony ; Noori, Muna ; Prior, Tomas ; Vasudeva, Akhila ; Wimalasundera, Ruwan C. / Perinatal- and procedure-related outcomes following radiofrequency ablation in monochorionic pregnancy. In: American Journal of Obstetrics and Gynecology. 2014 ; Vol. 210, No. 5.
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Perinatal- and procedure-related outcomes following radiofrequency ablation in monochorionic pregnancy. / Kumar, Sailesh; Paramasivam, Gowrishankar; Zhang, Eko; Jones, Bryony; Noori, Muna; Prior, Tomas; Vasudeva, Akhila; Wimalasundera, Ruwan C.

In: American Journal of Obstetrics and Gynecology, Vol. 210, No. 5, 01.01.2014.

Research output: Contribution to journalArticle

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AB - Objective We sought to assess the efficacy, complication rates, and outcomes for complex monochorionic pregnancies undergoing selective fetal reduction using radiofrequency ablation (RFA). Study Design In this prospective observational study, 100 consecutive cases of selective fetal reduction using RFA were analyzed. All cases were managed at the Centre for Fetal Care at Queen Charlotte's and Chelsea Hospital in London. Indications for offering RFA, details of the procedure, and pregnancy outcomes were collected and analyzed. Results The main indications for RFA were discordant fetal anomaly and twin-twin transfusion syndrome. Overall live birth rate was 78% and the median gestation at delivery was 35.15 weeks. Delivery <32 weeks' gestation occurred in 17.9% of cases. Postprocedure abnormal antenatal magnetic resonance imaging occurred in 3% of cases. There was no statistical difference in outcomes with regard to gestation when the procedure was performed or the indication for the RFA. Conclusion RFA appears to be a reasonable option for selective fetal reduction in complex monochorionic pregnancies with an overall survival rate of 78%.

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