Iranian Journal of Medical Sciences

Document Type : Original Article(s)


1 Department of Obstetrics and Gynecology, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran

2 Maternal Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran

3 Department of Perinatology, Maternal, Fetal and neonatal Research Center, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran

4 Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran

5 Department of Obstetrics and Gynecology, Kermanshah University of Medical Sciences, Kermanshah, Iran


Background: This study aimed to investigate and compare the perinatal and neonatal outcomes of monochorionic twin pregnancies complicated with fetal growth restriction (sFGR) with or without twin-to-twin transfusion syndrome (TTTS) after cord occlusion by radiofrequency ablation (RFA).
Methods: This prospective cross-sectional study was conducted in women with monochorionic twin pregnancies of 16 to 26 weeks of gestational age (GA) in an academic hospital from 2016 to 2020. Demographic and obstetrical characteristics such as cervical length, GA of RFA and delivery, amnioreduction, cesarean section (C/S) rate, and maximum vertical pocket as well as perinatal, neonatal, and maternal outcomes were evaluated and compared between groups using Statistical Package for the Social Sciences (SPSS). Mann-Whitney U test or independent t test was used for quantitative data and Chi-square test was applied for comparing qualitative variables. The significance level of tests was 0.05.
Results: Totally 213 (106 sFGR and 107 TTTS+sFGR) cases were enrolled. The mean of maternal age (P=0.787), body mass index (P=0.932), gestational age at RFA (P=0.265), as well as gestational age of delivery (P=0.482), and C/S rate (P=0.124) were not significant between the two groups, but a significant difference (P<0.001) in cervical length was observed between the two groups. No significant differences were observed in newborn and fetal outcomes such as fetal demise (P=0.827), PPROM (P=0.233), abortion (P=0.088), and admission to intensive care unit (P=0.822) between the groups.
Conclusion: Although we expected worse fetal and neonatal outcomes in the TTTS+sFGR group after RFA, no significant difference was observed between groups.