Intrafetal Laser Treatment for Selective Feticide in Monochorionic Multiple Pregnancies

Abstract

Intrafetal coagulation by a radiofrequency ablation (RFA) device has traditionally been used for selec tive feticide in complicated monochorionic multiple pregnancies. However, as RFA is not feasible in early pregnancy, intrafetal laser coagulation has recently been suggested as an alternative method in the early midtrimester period. This study aimed to report our experience of utilizing intrafetal laser coagulation for selective feticide in early complicated monochorionic multiple pregnancies. Three monochorionic multiple pregnancies that were treated with intrafetal laser coagulation before 20 weeks were described. Sonographic findings during pregnancy, antepartum course, and intrafetal laser coagulation procedure were reviewed, along with their perinatal outcomes. Indications were twin reversed arterial perfusion sequence in two cases, and dichorionic triamniotic triplets compli cated with twintotwin transfusion syndrome in one case. Intrafetal laser coagulation was successful in all three cases, with favorable neonatal outcomes.