Cord ultrasonic transection procedure for selective termination of a monochorionic twin

John B. Lopoo, Bettina W. Paek, Geoffrey A. Maichin, Gerald S. Lipshutz, Russell W. Jennings, Diana L Farmer, Per L. Sandberg, Vickie A. Feldstein, Roy A. Filly, Jody A. Farrell, Michael R. Harrison, Craig T. Albanese

Research output: Contribution to journalArticlepeer-review

43 Scopus citations


Placental vascular communications can present a life-threatening problem in monochorionic twins when one fetus has a lethal anomaly. Although selective feticide is the best option for salvaging the normal twin, techniques normally employed (i.e. intracardiac potassium, air embolism) are not prudent given the common circulatory system. Furthermore, in monoamniotic, monochorionic twin gestations it is important to transect the umbilical cord completely to prevent entanglement of the dead fetus around the cord of the normal twin. We present two cases of monochorionic twins in which the cords were transected with a harmonic scalpel under ultrasonic guidance via one trocar. The harmonic scalpel is an instrument which can simultaneously coagulate and cut blood vessels or tissues. The cord ultrasonic transection procedure is a novel, minimally invasive technique which offers several advantages over the methods currently used for selective feticide in discordant monochorionic twin gestations. Copyright (C) 2000 S. Karger AG, Basel.

Original languageEnglish (US)
Pages (from-to)177-179
Number of pages3
JournalFetal Diagnosis and Therapy
Issue number3
StatePublished - May 2000


  • Cord ultrasonic transection procedure
  • Feticide, selective
  • Twin reversed arterial perfusion syndrome
  • Twins, discordant

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Pediatrics, Perinatology, and Child Health


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