Department of Fetal Medicine and Prenatal Diagnosis Center, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China.
Prenat Diagn. 2018 Jun;38(7):499-503. doi: 10.1002/pd.5269. Epub 2018 May 9.
Radiofrequency ablation (RFA) is a management alternative for complicated monochorionic twin pregnancies. The purpose of this study is to evaluate risk factors for fetal death after RFA.
An observational study was performed to document the perinatal outcomes of all cases undergoing fetal reduction using RFA from 2010 to 2016 at the Shanghai First Maternity and Infant Hospital. A multiple regression model was built to identify predictors of the death of the remaining fetus after RFA.
A total of 183 patients treated with RFA for fetal reduction were analyzed, including 53 selective intrauterine growth restriction, 35 twin-twin transfusion syndrome, 36 dichorionic triamniotic triplets, 24 monochorionic twins discordant for fetal anomaly, and 35 twin reversed arterial perfusion. The prevalence of fetal death after RFA was 23% (43:183). The occurrence of fetal death after RFA was independently associated with more than 2 cycles of RFA coagulation (OR 3.46; 95% CI, 1.34-8.94; P = .01).
More than 2 cycles of RFA coagulation is the only independent risk factors of fetal death after RFA.
射频消融（RFA）是复杂性单绒毛膜双胎妊娠的一种治疗选择。本研究旨在评估 RFA 后胎儿死亡的危险因素。
对 2010 年至 2016 年在上海第一妇婴保健院行胎儿减灭术的所有 RFA 患者的围产结局进行了观察性研究。建立了多元回归模型，以确定 RFA 后剩余胎儿死亡的预测因素。
共分析了 183 例接受 RFA 治疗的患者，其中选择性宫内生长受限 53 例，双胎输血综合征 35 例，双绒三羊 36 例，单绒双胎胎儿畸形不一致 24 例，双胎反向动脉灌注 35 例。RFA 后胎儿死亡的发生率为 23%（43/183）。RFA 后胎儿死亡的发生与 RFA 凝固多于 2 个周期独立相关（OR 3.46；95%CI，1.34-8.94；P =.01）。
RFA 凝固多于 2 个周期是 RFA 后胎儿死亡的唯一独立危险因素。
