{"title":"Short- and Long-Term Outcome of Selective Reduction by Fetoscopy-Guided Bipolar Cord Coagulation in Monochronic Twin Pregnancies.","authors":"Huirong Tang, Chenyan Dai, Chenchen Yan, Jie Li, Yimin Dai, Xian Xiao, Liang Jin, Yali Hu, Mingming Zheng","doi":"10.1159/000539462","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to assess the short- and long-term outcome of selective reduction by fetoscopy-guided bipolar cord coagulation in monochronic twin pregnancies.</p><p><strong>Methods: </strong>Retrospective analysis was conducted of a consecutive cohort of all monochorionic twin pregnancies treated with fetoscopy-guided bipolar cord coagulation between December 2015 and December 2022 in a single center in China.</p><p><strong>Results: </strong>A total of 43 monochronic twin pregnancies undergoing fetoscopy-guided bipolar cord coagulation were analyzed. There were 5 intrauterine deaths with an 88.4% (38/43) survival rate overall. The preterm premature rupture of the membranes rate was 13.2%, and the preterm birth before 37 and 32 weeks was 42.1% and 13.1%, respectively. An uptrend in the survival rate (78.9 vs. 95.8%, p = 0.086) and a downtrend of procedure time (30 vs. 16.5 min, p = 0.036) were observed over time (period 1 from December 2015 to December 2019 verses period 2 from January 2020 to December 2022). Long-term outcome was assessed in 94.6% (35/37) of survivors, and 91.4% (32/35) had normal neurodevelopmental outcome.</p><p><strong>Conclusion: </strong>Fetoscopy-guided bipolar cord coagulation for fetal reduction in complicated monochorionic twin pregnancies could achieve a favorable short- and long-term outcome, especially in experienced hands.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"516-524"},"PeriodicalIF":1.6000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Fetal Diagnosis and Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000539462","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/5 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: The aim of this study was to assess the short- and long-term outcome of selective reduction by fetoscopy-guided bipolar cord coagulation in monochronic twin pregnancies.
Methods: Retrospective analysis was conducted of a consecutive cohort of all monochorionic twin pregnancies treated with fetoscopy-guided bipolar cord coagulation between December 2015 and December 2022 in a single center in China.
Results: A total of 43 monochronic twin pregnancies undergoing fetoscopy-guided bipolar cord coagulation were analyzed. There were 5 intrauterine deaths with an 88.4% (38/43) survival rate overall. The preterm premature rupture of the membranes rate was 13.2%, and the preterm birth before 37 and 32 weeks was 42.1% and 13.1%, respectively. An uptrend in the survival rate (78.9 vs. 95.8%, p = 0.086) and a downtrend of procedure time (30 vs. 16.5 min, p = 0.036) were observed over time (period 1 from December 2015 to December 2019 verses period 2 from January 2020 to December 2022). Long-term outcome was assessed in 94.6% (35/37) of survivors, and 91.4% (32/35) had normal neurodevelopmental outcome.
Conclusion: Fetoscopy-guided bipolar cord coagulation for fetal reduction in complicated monochorionic twin pregnancies could achieve a favorable short- and long-term outcome, especially in experienced hands.
目的评估胎儿镜引导下双极脐带凝结术对单绒毛膜双胎妊娠选择性减胎的短期和长期疗效:方法:回顾性分析2015年12月至2022年12月期间在中国某中心接受胎儿镜引导下双极脐带凝固术治疗的所有单卵双胎妊娠:结果:共分析了43例接受胎儿镜引导下双极脐带凝固术的单绒毛膜双胎妊娠。共有 5 例胎死宫内,总存活率为 88.4%(38/43)。胎膜早破率为13.2%,37周和32周前早产率分别为42.1%和13.1%。随着时间的推移(第一阶段从2015年12月至2019年12月,第二阶段从2020年1月至2022年12月),观察到存活率呈上升趋势(78.9% vs 95.8%,P=0.086),手术时间呈下降趋势(30分钟 vs 16.5分钟,P=0.036)。94.6%(35/37)的幸存者接受了长期结果评估,91.4%(32/35)的幸存者神经发育结果正常:结论:胎儿镜引导下的双极脐带凝固术可为复杂的单绒毛膜双胎妊娠带来良好的短期和长期效果,尤其是在经验丰富的医生手中。
期刊介绍:
The first journal to focus on the fetus as a patient, ''Fetal Diagnosis and Therapy'' provides a wide range of biomedical specialists with a single source of reports encompassing the common discipline of fetal medicine.