The Role of Selective Reduction - Part 1
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The Role of Selective Reduction - Part 1
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*SPECIAL GUEST* - Dr. Saul Snowise – Part 1 of 2
This week and next week we have a two-part series with Dr. Saul Snowise as we discuss the role of selective reduction, specifically in the setting of monochorionic twins. Join us as we discuss the following this week:
- How selective reduction differs in monochorionic vs. dichorionic twins
- Most common method of selective reduction
- Potassium chloride (KCl) injection contraindicated in monochorionic twins
- Method for monochorionic pregnancy
- Cord occlusion
- Most common method of selective reduction
- Indications for selective reduction in monochorionic twins
- Selective fetal growth restriction (sIUGR)
- Discordant anomalies
- Twin-twin transfusion syndrome (TTTS)
- Twin reverse arterial perfusion (TRAP) sequence
- Failed laser
- Various methods for performing a cord occlusion selective reduction
- Microwave
- Interstitial laser
- Radiofrequency ablation (RFA)
- Bipolar cautery
- Sizes of operative instruments, energy levels used and the treatment protocols
- Gestational age thresholds for performing a selective reduction procedure
- Risks associated with a selective reduction procedure
- Membrane complications (i.e. PPROM)
- Preterm delivery
- Bleeding, infection
- Loss of co-twin
- Pre-operative counseling with patients
- Follow-up and surveillance for the remainder of the pregnancy
Tune in next week for part 2!
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