Monopolar thermocoagulation in the management of acardiac twins

Ping Jian Chang, Jui Der Liou, Ching Chang Hsieh, An Shine Chao*, Yung Kuei Soong

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

12 Scopus citations


Objective: To demonstrate the equipment setup and the application of monopolar thermocoagulation in the management of acardiac twins. Methods: We described 2 cases of acardiac acephalus twins who developed congestive heart failure and polyhydramnios at 20 weeks of gestation. A monopolar wire electrode was inserted through a 14-gauge trocar under ultrasound guidance. The inter-twin circulation was interrupted and confirmed by color Doppler flow examination. Results: Case 1 was detected at 20 weeks of gestation with progression to early signs of fetal congestive heart failure at 22 weeks. This case had smooth operative procedure and delivered a healthy infant at 32 weeks. Case 2 was referred at 24 weeks of gestation with marked fetal congestive heart failure. Although thermocoagulation cessed the intertwin perfusion, the fetus died in utero 12 h later with persistent irreversible circulatory compensation. Conclusion: Monopolar thermocoagulation was an effective and generally available alternative technique to fetal endoscopic surgery for the interruption of vascular communication between acardiac twins.

Original languageEnglish
Pages (from-to)271-274
Number of pages4
JournalFetal Diagnosis and Therapy
Issue number3
StatePublished - 2004
Externally publishedYes


  • Acardiac twins
  • Thermocoagulation


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