Selective Fetal Reduction In Complicated Monochorionic Twin By A Singletine Cool Tip Radiofrequency  Ablator As Compared To Already Published Data Using Multitine Radiofrequency Ablator - A Single Center Experience

Vikneswaran S Chendirasagaram; Buvanes Chelliah

doi:10.36948/ijfmr.2026.v08i04.86620

Selective Fetal Reduction In Complicated Monochorionic Twin By A Singletine Cool Tip Radiofrequency Ablator As Compared To Already Published Data Using Multitine Radiofrequency Ablator - A Single Center Experience

Author(s)	Dr. Vikneswaran S Chendirasagaram, Dr. Buvanes Chelliah
Country	Malaysia
Abstract	Aim To evaluate perinatal outcomes in women with complicated monochorionic pregnancies who underwent selective fetal reduction (SFR) using radiofrequency ablation (RFA) by a cool-tip, single tine ablator and compare our results with already published studies on RFA done using multi-tine needle. Materials and methods This is a retrospective study, including patients with complicated monochorionic pregnancies who underwent SFR using the single tine RFA (17gauge cool tip RFA needle from Covidien) during the study period from January 2024 to December 2025 from Maternal Fetal Medicine unit in Hospital Tunku Azizah, Kuala Lumpur. Results 16 women with complicated monochorionic pregnancies underwent RFA including 10 for twin reversed arterial perfusion (TRAP) sequence, 4 for discordant major fetal anomalies, 1 with selective fetal growth restriction (sFGR) and 1 with twin-to-twin transfusion syndrome (TTTS). The average maternal age was 31.3 years (27 to 40 years). The mean gestational age at the time of the procedure was 21.4 weeks (ranged from 17.4 to 26.3 weeks). RFA was technically successful in achieving SFR in all. At an average 1.8 ablation cycles and an average of 3.2 minutes duration of ablation per cycle were needed for complete cessation of blood flow. The mean gestational age at delivery among the live born was 35.1 weeks. The overall survival was 87.5 % (14/16) with co-twin loss of 0.06 % (1/16), miscarriage of 0.06 % (1/16) and 0.06 % (1/16) had PPROM within 4 weeks of the procedure. The pregnancy success rates among TRAP sequence, TTTS and discordant anomaly groups were 90 % (9/10), 100 % (1/1), and 80 % (4/5) respectively. There were no maternal complications documented in all the cases. Conclusion This study shows that the pregnancy outcome using a single-tine cool tip RFA needle in carefully selected cases shows a better outcome as compared to other studies which used multi-tine RFA needle. Single-tine cool tip RFA needle has advantages of having technical simplicity, higher precision, lower risk of collateral thermal injury and lower cost, thus, making it a preferable option for selective fetal reduction in complicated monochorionic twin.
Keywords	Radiofrequency ablation, Fetal therapy, Twin-twin transfusion syndrome, Selective fetal growth restriction, TRAP twin
Field	Medical / Pharmacy
Published In	Volume 8, Issue 4, July-August 2026
Published On	2026-08-28
DOI	https://doi.org/10.36948/ijfmr.2026.v08i04.86620

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Selective Fetal Reduction In Complicated Monochorionic Twin By A Singletine Cool Tip Radiofrequency Ablator As Compared To Already Published Data Using Multitine Radiofrequency Ablator - A Single Center Experience

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