Short- and Long-Term Outcome of Selective Reduction by Fetoscopy-Guided Bipolar Cord Coagulation in Monochronic Twin Pregnancies

Abstract

Objective: To assess the short and long-term outcome of selective reduction by fetoscopy-guided bipolar cord coagulation in monochronic twin pregnancies. Methods: Retrospective analysis 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 survival rate (78.9% vs 95.8%, p=0.086) and a downtrend of procedure time (30 vs 16.5minutes, p=0.036) were observed over time (period 1 from Dec.2015 to Dec.2019 verses period 2 from Jan. 2020 to Dec. 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.