Why Is Radiofrequency Ablation Performed On The Fetus?
RFA is considered a procedural option for complications in monozygotic twin pregnancies (monochorionic diamniotic - MCDA and monochorionic monoamniotic - MCMA), such cases are:
- In case of an acardial fetus / TRAP (Twin reversed arterial perfusion) sequence (in 1% of monozygotic twins). An acardiac twin is a twin that lacks normal cardiac development and feeds parasitically on its twin with abnormal vascular connections to stay alive. As the week of gestation progresses, it also poses a risk to its normal twin partner.
- In cases of severe twin partner abnormalities in MC twin pregnancies.
- In cases of abnormal Doppler findings and severe growth retardation in MC twin pregnancies.
- In cases of twin-to-twin transfusion (TTTS) with a high risk of twin death or brain injury
RFA is used to stop the supply of cord blood to the affected fetus and maintain the pregnancy with a single fetus. This procedure involves sending a current through an electrode that causes cellular heating in the affected area (umbilical cord entrance and surrounding area) and occlusion of the vessels around the tissue.
How Is Radiofrequency Ablation Performed On The Fetus?
Expectant mothers are asked to fast before the procedure. The area to be treated is locally anesthetized. Then, a special needle electrode developed for this procedure is inserted into the target area from the mother’s abdomen under ultrasound guidance. During the procedure, which lasts 8-10 minutes, the tissue is treated with electricity and the targeted blood flow disturbance is confirmed by Doppler ultrasound. The expectant mother is discharged home after a few hours of observation.
What Can Happen After Radiofrequency Ablation?
As with all other intrauterine procedures, the expectant mother is monitored for complications such as preterm labor, premature rupture of membranes, hemorrhage, and infection.
