九例射频消融选择性减胎术的疗效及观察

目的:探讨射频消融减胎术(radio frequency ablation,RFA)对复杂性多胎妊娠的疗效.方法:回顾性分析2017年4月—2019年5月在武汉大学人民医院行RFA治疗的9例患者的临床资料,总结其临床疗效,包括流产、早产、足月产、活产、分娩方式和新生儿体质量等.结果:9例患者中有2例是双绒毛膜三羊膜囊妊...

Efficacy and Observation of Radiofrequency Ablation Selective Fetal Reduction in Nine Cases

Objective: To investigate the treatment effect of radio frequency ablation (RFA) on fetal reduction. Methods: The clinical data of 9 patients undergoing RFA for the fetal reduction in our hospital from April 2017 to May 2019 were retrospectively analyzed, including the average age of the patients, the number of pregnancies, the mode of pregnancy, the gestational weeks at the time of the fetal reduction, the indications of fetal reduction and the pregnancy outcome. The clinical efficacy was summarized, including abortion, premature delivery, full-term birth, live birth, mode of delivery, neonatal weight, etc. Results: Among the 9 cases, 2 cases were dichorionic triamniotic (DCTA) triplet pregnancies, 5 cases were monochorionic diamniotic (MCDA) twin conceived, which one of the twins underwent fetal reduction due to disorder fetal anomalies, 1 case was twin transfusion syndrome (TTTS), and 1 case was one of the twins with selective fetal growth restriction (sFGR) type Ⅱ. Nine pregnant women were operated successfully in a one-time RFA procedure. The procedure was technically successful in all cases. There were no operative complications. Only one case had miscarriage 2 weeks after the operation, and the rest gave birth to the newborns. Good pregnancy outcome was achieved and the clinical effect was significant. Conclusions: RFA is a safe, effective and minimally invasive intrauterine treatment for complicated multiple pregnancies, and the appropriate method of fetal reduction should be selected by chorionicity and patient′s willingness.