单绒毛膜性多胎射频消融选择性减胎术后妊娠结局分析OA

Objective:To study the efficacy of radiofrequency ablation in multiple monochorionic fetal reduction with different indications.Methods:From January 1,2015 to July 1,2024,the clinical data of 60 pregnant women with multiple monochorionic pregnancies who had given birth after receiving radiofrequency ablation in the Depart-ment of Obstetrics and Gynecology,the First Affiliated Hospital of Army Military Medical University were retrospec-tively analyzed.Among them,51 twins and 9 triplets were divided into 8 groups according to different indications of fetal reduction.They were selective intrauterine growth restriction(sIUGR)group(11 cases),twin transfusion syn-drome(TTTS)group(14 cases),twin reverse arterial perfusion sequence(TRAPS)group(5 cases),TTTS com-bined with sIUGR group(5 cases),twin anemia and polycythemia(TAPS)group(4 cases),one of the twins with abnormal development group(9 cases),three pregnancies group(9 cases)and pregnancies with severe mater-nal pregnancy Complication group(3 cases).Comparison of maternal age,gestational age of operation,ablation cycle,operation duration,gestational age of delivery,maternal and infant complications and pregnancy outcomes among groups.Results:The overall survival rate of the preserved fetus was 78.33％.The mean gestational weeks of operation and delivery were 21.20±3.40 weeks and 35.70±3.40 weeks respectively.The mean number of ablation times was 1.50±0.60,and there was no statistically significant difference in age,ablation cycle and op-eration duration among the groups of patients(P>0.05),but there was a statistically significant difference in ges-tational age during the operation(P=0.002).There were no significant differences in postoperative complications and pregnancy outcomes among all groups(P>0.05).However,it can be seen from the data that the abortion rate of TRAPS group was the highest(40.00％),the complication rate of the TTTS group was the highest(42.86％),and the mean gestational age of delivery was the earliest(33.36±5.02 weeks).Conclusions:Radio-frequency ablation is safe and effective in the treatment of complex monochorionic pregnancies without serious maternal complications.However,the highest rate of miscarriage was found in the TRAPS group and the highest rate of complications was found in the TTTS group.Therefore,according to different fetal reduction indicators,it is necessary to choose the appropriate intervention time and formulate individual treatment plans to improve preg-nancy outcomes.