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Vol. 33, No. 4, 2013
Issue release date: May 2013
Fetal Diagn Ther 2013;33:224-229

The North American Fetal Therapy Network Registry Data on Outcomes of Radiofrequency Ablation for Twin-Reversed Arterial Perfusion Sequence

Lee H. · Bebbington M. · Crombleholme T.M. · for the North American Fetal Therapy Network (NAFTNet)
aDepartment of Surgery and the Fetal Treatment Center, University of California, San Francisco, Calif., bCenter for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, Pa., cTexas Center for Maternal and Fetal Treatment, Houston, Tex., dFetal Care Center of Cincinnati, Cincinnati Children's Hospital, University of Cincinnati, College of Medicine, Cincinnati, Ohio, and eColorado Institute for Maternal and Fetal Health and Colorado Fetal Care Center, Children's Hospital Colorado, Aurora, Colo., and Department of Surgery, University of Colorado School of Medicine, Denver, Colo., USA

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Objective: To report the North American Fetal Therapy Network (NAFTNet) Registry data on the outcomes of using radiofrequency ablation to treat twin-reversed arterial perfusion (TRAP). Methods: This was a retrospective review of the records of all patients who underwent percutaneous radiofrequency ablation of an acardiac twin after referral to 12 NAFTNet institutions between 1998 and 2008. Maternal, fetal and neonatal data were analyzed. The primary outcome was neonatal survival to 30 days of age. All participating sites conducted this study under institutional review board approval. Results: Of the 98 patients identified, there were no maternal deaths and no women required blood transfusions. Most women (76 of 98; 78%) stayed in the hospital for ≤1 day after the procedure. Mean gestational age at delivery was 33.4 weeks overall and 36.0 weeks for survivors. Median gestational age at delivery was 37.0 weeks. Survival of the pump twin to 30 days was 80% in the overall cohort. Conclusion: The NAFTNet registry data suggest that radiofrequency ablation of the acardiac twin is an effective treatment for TRAP sequence.

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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.
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