Bipolar coagulation of the umbilical cord in complicated monochorionic twin pregnancy. 2000

J A Deprest, and F Audibert, and D Van Schoubroeck, and K Hecher, and D Mahieu-Caputo
Department of Obstetrics and Gynecology, Universitair Ziekenhuis "Gasthuisberg," Leuven, Belgium.

OBJECTIVE In monochorionic twin pregnancy in which one twin is a nonviable fetus, selective feticide may be considered. We aimed to occlude the umbilical cord with a bipolar forceps for doing so. METHODS This was a multicenter experience in 10 consecutive patients either with twin-to-twin transfusion syndrome and one fetus affected by a condition not compatible with normal extrauterine life or with acardiac twinning. RESULTS There were no intraoperative problems, and the mean procedure time was 17.5 minutes. The flow was stopped in all 10 cases. Two cases were complicated by rupture of the fetal membranes within 2 days, and the pregnancies were terminated. The other 8 pregnancies resulted in the live birth of a healthy baby. The mean interval between procedure and birth was 15.1 weeks (range, 7-20 weeks). In one patient emergency cesarean delivery for abruptio placentae was done at 26 weeks, 7 weeks after the procedure. The other 7 patients were delivered beyond the 36th week of gestation. All 8 children are alive and well, with a mean follow-up of at least 1 year. CONCLUSIONS Bipolar coagulation is a safe, effective, and simple procedure for cord coagulation that is feasible through a single port and can be performed solely under ultrasonographic guidance.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D011248 Pregnancy Complications Conditions or pathological processes associated with pregnancy. They can occur during or after pregnancy, and range from minor discomforts to serious diseases that require medical interventions. They include diseases in pregnant females, and pregnancies in females with diseases. Adverse Birth Outcomes,Complications, Pregnancy,Adverse Birth Outcome,Birth Outcome, Adverse,Complication, Pregnancy,Outcome, Adverse Birth,Pregnancy Complication
D011256 Pregnancy Outcome Results of conception and ensuing pregnancy, including LIVE BIRTH; STILLBIRTH; or SPONTANEOUS ABORTION. The outcome may follow natural or artificial insemination or any of the various ASSISTED REPRODUCTIVE TECHNIQUES, such as EMBRYO TRANSFER or FERTILIZATION IN VITRO. Outcome, Pregnancy,Outcomes, Pregnancy,Pregnancy Outcomes
D005260 Female Females
D005333 Fetus The unborn young of a viviparous mammal, in the postembryonic period, after the major structures have been outlined. In humans, the unborn young from the end of the eighth week after CONCEPTION until BIRTH, as distinguished from the earlier EMBRYO, MAMMALIAN. Fetal Structures,Fetal Tissue,Fetuses,Mummified Fetus,Retained Fetus,Fetal Structure,Fetal Tissues,Fetus, Mummified,Fetus, Retained,Structure, Fetal,Structures, Fetal,Tissue, Fetal,Tissues, Fetal
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013525 Surgical Instruments Hand-held tools or implements used by health professionals for the performance of surgical tasks. Clamps, Surgical,Clips, Surgical,Clips, Tantalum,Forceps,Hooks, Surgical,Plugs, Surgical,Scissors, Surgical,Speculum,Surgical Clamps,Surgical Clips,Surgical Hooks,Surgical Plugs,Surgical Scissors,Surgical Valves,Trocar,Valves, Surgical,Clamp, Surgical,Clip, Surgical,Clips,Hook, Surgical,Instrument, Surgical,Plug, Surgical,Surgical Clamp,Surgical Clip,Surgical Hook,Surgical Plug,Surgical Valve,Valve, Surgical,Clip,Clip, Tantalum,Forcep,Instruments, Surgical,Speculums,Surgical Instrument,Tantalum Clip,Tantalum Clips,Trocars
D014430 Twins, Monozygotic Two off-spring from the same PREGNANCY. They are from a single fertilized OVUM that split into two EMBRYOS. Such twins are usually genetically identical and of the same sex. Twins, Identical,Identical Twin,Identical Twins,Monozygotic Twin,Monozygotic Twins,Twin, Identical,Twin, Monozygotic
D014470 Umbilical Cord The flexible rope-like structure that connects a developing FETUS to the PLACENTA in mammals. The cord contains blood vessels which carry oxygen and nutrients from the mother to the fetus and waste products away from the fetus. Cord, Umbilical,Cords, Umbilical,Umbilical Cords

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