• The Role of Selective Reduction - Part 1

  • Aug 21 2023
  • Length: 24 mins
  • Podcast

The Role of Selective Reduction - Part 1

  • Summary

  • *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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