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 journalArticle

41 Citations (Scopus)

Abstract

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
Volume15
Issue number3
StatePublished - May 2000

Fingerprint

Ultrasonics
Blood Vessels
Fetus
Air Embolism
Pregnancy
Umbilical Cord
Cardiovascular System
Surgical Instruments
Potassium

Keywords

  • 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

Cite this

Lopoo, J. B., Paek, B. W., Maichin, G. A., Lipshutz, G. S., Jennings, R. W., Farmer, D. L., ... Albanese, C. T. (2000). Cord ultrasonic transection procedure for selective termination of a monochorionic twin. Fetal Diagnosis and Therapy, 15(3), 177-179.

Cord ultrasonic transection procedure for selective termination of a monochorionic twin. / Lopoo, John B.; Paek, Bettina W.; Maichin, Geoffrey A.; Lipshutz, Gerald S.; Jennings, Russell W.; Farmer, Diana L; Sandberg, Per L.; Feldstein, Vickie A.; Filly, Roy A.; Farrell, Jody A.; Harrison, Michael R.; Albanese, Craig T.

In: Fetal Diagnosis and Therapy, Vol. 15, No. 3, 05.2000, p. 177-179.

Research output: Contribution to journalArticle

Lopoo, JB, Paek, BW, Maichin, GA, Lipshutz, GS, Jennings, RW, Farmer, DL, Sandberg, PL, Feldstein, VA, Filly, RA, Farrell, JA, Harrison, MR & Albanese, CT 2000, 'Cord ultrasonic transection procedure for selective termination of a monochorionic twin', Fetal Diagnosis and Therapy, vol. 15, no. 3, pp. 177-179.
Lopoo JB, Paek BW, Maichin GA, Lipshutz GS, Jennings RW, Farmer DL et al. Cord ultrasonic transection procedure for selective termination of a monochorionic twin. Fetal Diagnosis and Therapy. 2000 May;15(3):177-179.
Lopoo, John B. ; Paek, Bettina W. ; Maichin, Geoffrey A. ; Lipshutz, Gerald S. ; Jennings, Russell W. ; Farmer, Diana L ; Sandberg, Per L. ; Feldstein, Vickie A. ; Filly, Roy A. ; Farrell, Jody A. ; Harrison, Michael R. ; Albanese, Craig T. / Cord ultrasonic transection procedure for selective termination of a monochorionic twin. In: Fetal Diagnosis and Therapy. 2000 ; Vol. 15, No. 3. pp. 177-179.
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