RFA is a procedure utilized to stop the blood flow in an abnormal fetus. It uses a small needle device that is inserted by ultrasound guidance to identify the insertion of the umbilical cord to the fetus. The needle is turned "on" until there is no more blood flow going to the fetus. The advantage of this technique is the small size of the RFA needle which minimizes the risks of preterm labor. The remains of the abnormal fetus will either become smaller or pass during delivery.

Which Conditions Are Treated With Radio-Frequency Ablation?

RFA procedures are typically utilized in abnormal twin pregnancies. Your doctors may have identified a condition in which one abnormal twin is threatening the life of the other normal twin. In these situations, it may be necessary to stop the blood flow to the abnormal twin. RFA has been utilized in many obstetrical diseases but has mostly been performed for Twin Reverse Arterial Perfusion Sequence (TRAP). For twin pregnancies with an acardiac/acephalic twin, the abnormal fetus can be a cardiac burden on the normal twin and cause heart failure. As a result, RFA can be utilized to stop the connection between the two fetuses.
The recommendation to perform RFA for TRAP sequence will be determined by your team of doctors at the Center.

What Special Considerations Should Be Made at Time of Delivery ?

Type of delivery : Typically, RFA procedures do not require Cesarean delivery. The need for this fetal intervention should not impact your type of delivery. The delivery plan should be carefully discussed between the mother and the obstetrician.
Place of delivery : If all the prenatal monitoring suggests that your baby is doing well, the baby can be delivered at the hospital of your choice. However, the hospital should be prepared to handle any intensive care of your newborn and have a neonatal intensive care unit with the capability to provide specialized care.
Time of delivery : Unless there are signs of fetal heart failure due to the TRAP sequence or complications from the RFA procedure, there is no reason to intentionally induce early delivery. After the RFA procedure, your pregnancy will be continual to be monitored. If your baby is far enough along to survive delivery, the team at the Center may recommend early delivery for pregnancies that appear to be in danger.

What Will Happen at the Radio-Frequency Ablation Procedure ?

The entire team will carefully plan for the RFA procedure with preparation to handle all potential complications. Generally, the procedure is performed under IV sedation and local anesthesia. Your doctors will repeat a detailed ultrasound to confirm the problem and identify the abnormal twin and identify a pathway for the RFA needle that avoids the other twin and the placenta. A small skin incision is made to allow the placement of the RFA needle. The RFA needle is activated until blood flow is stopped in the abnormal twin. On occasion, the RFA procedure cannot be performed with a small skin incision due to the location of the fetuses and placenta in the uterus. In these situations, the procedure requires a larger incision to expose the uterus in order to provide a safe window for the RFA needle.
The RFA procedure is performed in the operating room with all the special equipment necessary to ensure the safety of you and your baby. Afterwards, the mother will be admitted to the Women's Center to monitor for preterm labor and complications at Children's Memorial Hermann Hospital.

Is radiofrequency ablation safe during pregnancy ?

RFA is probably safe for both pregnant patients and their fetus, and it can be an applicable choice for the management of patients with HCC during the second trimester until radical surgery can be accomplished.

When is radiofrequency ablation used ?

Radiofrequency ablation, or RFA, is a minimally invasive technique that shrinks the size of tumors, nodules or other growths in the body. RFA is used to treat a range of conditions, including benign and malignant tumors, chronic venous insufficiency in the legs, as well as chronic back and neck pain.