『The Role of Selective Reduction - Part 1』のカバーアート

The Role of Selective Reduction - Part 1

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
  • 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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