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
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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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