Interstitial laser: a new surgical technique for twin reversed arterial perfusion sequence in early pregnancy

Current treatments for twin reversed arterial perfusion sequence are associ ated with significant morbidity and most are not feasible in early gestatio n. We report the use of an interstitial laser in two pregnancies complicate d by this sequence at 14 and 15 weeks, respectively. A 600 mum laser fibre was introduced via a 17 gauge needle into the abdomen of the perfused twin close to the vitelline artery and umbilical vein, which were occluded by ne odymium:yttrium aluminium garnet (Nd:YAG) laser. Both pregnancies continued uneventfully and each resulted in the birth of a healthy baby at term.