A rare and life-saving fetal procedure performed at Yashoda Hospitals, Hitec City

The team at Yashoda Hospitals successfully performed selective fetal reduction in a monochorionic twin pregnancy using single-tine cool-tip radiofrequency ablation (RFA) under ultrasound guidance

Hyderabad: In a first-of-its-kind case in Hyderabad, the team at Yashoda Hospitals successfully performed selective fetal reduction in a monochorionic twin pregnancy using single-tine cool-tip radiofrequency ablation (RFA) under ultrasound guidance.

This advanced fetal procedure was carried out by Dr Navya, Senior Consultant in Fetal Medicine, to manage Selective Fetal Growth Restriction (SFGR Type III)—a condition where the poor growth of one twin can put both lives at risk.

Speaking about this groundbreaking case, Dr Navya said, “With the increasing trend of multiple pregnancies, especially due to assisted reproductive techniques (ART), specific types of identical twin pregnancies, i.e., monochorionic twins (MC), are also becoming more common. Most monochorionic pregnancies progress uneventfully to term. However, around 15–20% may develop complications such as Selective Fetal Growth Restriction (SFGR), Twin-to-Twin Transfusion Syndrome (TTTS), and Twin Reversed Arterial Perfusion (TRAP) sequence.”

These complications arise due to the shared blood vessels between the twins. If the affected twin demises, there is a 90% risk of co-twin demise and a 50–60% risk of neurological complications in the surviving twin. Fetal interventions such as RFA and Fetoscopic Laser Ablation (FLA), if performed at the appropriate time, can be life-saving for one or both twins.

“We used a newer, safer technique—cool-tip single-tine RFA—at 21 weeks of gestation to selectively reduce the severely affected twin suffering from Type III SFGR. By doing so, we were able to protect the healthier twin and prevent potential neurological complications,” Dr Navya said.