Abstract
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 language | English |
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Pages (from-to) | 271-274 |
Number of pages | 4 |
Journal | Fetal Diagnosis and Therapy |
Volume | 19 |
Issue number | 3 |
DOIs | |
State | Published - 2004 |
Externally published | Yes |
Keywords
- Acardiac twins
- Thermocoagulation