Pregnancy outcomes following bipolar umbilical cord cauterization for selective termination in complicated monochorionic multiple gestations

John G. Ilagan; R. Douglas Wilson; Michael Bebbington; Mark P. Johnson; Holly L. Hedrick; Kenneth W. Liechty; N. Scott Adzick

doi:10.1159/000111598

Pregnancy outcomes following bipolar umbilical cord cauterization for selective termination in complicated monochorionic multiple gestations

John G. Ilagan, R. Douglas Wilson, Michael Bebbington, Mark P. Johnson, Holly L. Hedrick, Kenneth W. Liechty, N. Scott Adzick

Department of Obstetrics & Gynecology

Research output: Contribution to journal › Article › peer-review

16 Scopus citations

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.

Original language	English
Pages (from-to)	153-158
Number of pages	6
Journal	Fetal Diagnosis and Therapy
Volume	23
Issue number	2
DOIs	https://doi.org/10.1159/000111598
State	Published - Feb 2008

Keywords

Bipolar umbilical cord cauterization
Selective termination
Twin reversed arterial perfusion sequence
Twin-to-twin transfusion

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10.1159/000111598

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title = "Pregnancy outcomes following bipolar umbilical cord cauterization for selective termination in complicated monochorionic multiple gestations",

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.",

keywords = "Bipolar umbilical cord cauterization, Selective termination, Twin reversed arterial perfusion sequence, Twin-to-twin transfusion",

author = "Ilagan, {John G.} and Wilson, {R. Douglas} and Michael Bebbington and Johnson, {Mark P.} and Hedrick, {Holly L.} and Liechty, {Kenneth W.} and Adzick, {N. Scott}",

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doi = "10.1159/000111598",

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AU - Ilagan, John G.

AU - Wilson, R. Douglas

AU - Bebbington, Michael

AU - Johnson, Mark P.

AU - Hedrick, Holly L.

AU - Liechty, Kenneth W.

AU - Adzick, N. Scott

PY - 2008/2

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N2 - 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.

AB - 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.

KW - Bipolar umbilical cord cauterization

KW - Selective termination

KW - Twin reversed arterial perfusion sequence

KW - Twin-to-twin transfusion

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Pregnancy outcomes following bipolar umbilical cord cauterization for selective termination in complicated monochorionic multiple gestations

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