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Table of Contents
Vol. 23, No. 2, 2008
Issue release date: March 2008
Section title: Paper
Fetal Diagn Ther 2008;23:145–150
(DOI:10.1159/000111598)

Pregnancy Outcomes following Bipolar Umbilical Cord Cauterization for Selective Termination in Complicated Monochorionic Multiple Gestations

Ilagan J.G. · Wilson R.D. · Bebbington M. · Johnson M.P. · Hedrick H.L. · Liechty K.W. · Adzick N.S.
Center for Fetal Diagnosis and Treatment at the Children’s Hospital of Philadelphia, Department of Surgery and Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia, Pa., USA

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Article / Publication Details

First-Page Preview
Abstract of Paper

Received: 9/14/2006
Accepted: 11/30/2006
Published online: 11/26/2007

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 2

ISSN: 1015-3837 (Print)
eISSN: 1421-9964 (Online)

For additional information: http://www.karger.com/FDT

Abstract

Objective: To review pregnancy and childhood outcomes following selective termination by ultrasound guided bipolar umbilical cord cauterization (UCC) in complicated monochorionic multifetal pregnancies. Study Design: Consenting patients (27 of 49, 55%) had review of pregnancy history and pediatric development in the surviving twin following selective UCC. Results: UCC was performed at 21.2 ± 2.8 weeks gestational age, followed by a liveborn delivery (n = 28) at 34.4 ± 4.7 weeks. Mean birth weight was 2,218 ± 926 g. Complications included preterm labor (25.0%), premature rupture of membranes (17.8%), placental abruption (10.7%) and chorioamnionitis (7.1%). Perinatal mortality was 10.3% in continuing fetuses. However, 96.2% of pregnancies achieved livebirths with 96% of neonates showing apparently normal development between ages 1.5 and 5 years. Conclusion: Bipolar UCC is a reasonably safe and effective treatment for selective termination in complicated monochorionic pregnancies.


Article / Publication Details

First-Page Preview
Abstract of Paper

Received: 9/14/2006
Accepted: 11/30/2006
Published online: 11/26/2007

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 2

ISSN: 1015-3837 (Print)
eISSN: 1421-9964 (Online)

For additional information: http://www.karger.com/FDT


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

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    External Resources

  11. Taylor MJO, Shalev E: Tanawattancharoen S, Jolly M, Kumar S, Weiner E: Ultrasound guided umbilical cord occlusion using bipolar diathermy for stage III/IV twin-twin transfusion syndrome. Prenat Diagn 2002;22:70–76.
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  13. Fisk NM, Taylor MJO: The fetus with twin-twin transfusion syndrome; in Harrison M, Evans M, Adzick NS, Holzgreve W (eds): The Unborn Patient: The Art and Science of Fetal Therapy. Philadelphia, Saunders, 2000, pp 341–355.
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  15. Quintero RA, Chmait RH, Murakoshi T, Pankrac Z, Swiatkowska S, Bornick PW, Allen MH: Surgical Management of twin reversed arterial perfusion sequence. Am J Obstet Gynecol 2006;194:982–991.