Influence of indications on perinatal outcomes after radio frequency ablation in complicated monochorionic pregnancies: a retrospective cohort study

Abstract Background Radiofrequency ablation (RFA) is recommended to prevent potential neurological injury or intrauterine foetal death (IUFD) of the co-twin(s) in complicated monochorionic (MC) pregnancies. However, impacts various indications on pregnancy outcome following RFA remain unclear. This study aimed determine how influence perinatal outcomes MC pregnancies undergoing radiofrequency ablation. Methods was a retrospective cohort performed single centre. All consecutive treated with between July 2011 and 2019 were included. The adverse survival rate analysed based indications. continuous variables without normal distribution compared groups using Student’s t-test Mann–Whitney U test, respectively, for categorical variables, Chi-square Fisher’s exact tests used. P < 0.05 indicated significant difference. Results We 272 procedures 268 pregnancies, including 60 selective growth restriction (sIUGR), 64 twin–twin transfusion syndrome (TTTS), 12 twin reversed arterial perfusion sequence (TRAPs), 66 anomaly elective reduction (EFR) cases. overall co-twin 201/272 (73.9%). technical successful determined at 201/263 (76.7%). IUFD 20/272 (7.4%). TTTS group had recorded lowest (37/64, 57. 8%), significantly correlated Quintero stages (P = 0.029). Moreover, sIUGR III subgroup lower II (55.6%, versus 84.3%). gastroschisis exomphalos highest (4/10, 40%), followed by (2/9, 22.2%) dichorionic triamniotic (DCTA) (8/46, 17.9%). In EFR group, eight cases all coming from DCTA received before 17 weeks. Conclusions indications, IV incidence abdominal wall defect III. Elective after weeks may