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