Selective Bipolar Cord Coagulation Procedure

Selective bipolar cord coagulation (BCC) is a minimally invasive procedure that may be performed in utero in pregnancies in which one fetus is very sick and places the other in danger of death or permanent brain injury. In these cases, the best course of action may be to stop the blood supply to the sick fetus in order to protect the healthy one.

At Children’s Hospital of Philadelphia’s Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment, the BCC procedure is performed in utero using small, hollow instruments called trocars. These are inserted through the mother’s abdomen into the uterus. In most cases, your medical team will instruct you to arrive at the Hospital on the morning of the procedure, which is performed in the operating room using intravenous sedation for the mother.

Once the anesthesia has taken effect, the mother’s abdomen is prepped with an antibacterial solution and local anesthetic is given on the skin. Under sterile ultrasound guidance, two trocars are inserted through the mother’s abdomen and into the amniotic space. A small camera (fetoscope) and a coagulation device are then passed through the trocars into the amniotic cavity.

The coagulation device will be used to block blood flow to the parabiotic twin. After the blood flow is blocked, the coagulation device is removed and a small scissor is placed through the trocar to allow transection of the cord.

After surgery, you will be transferred to the Garbose Family Special Delivery Unit for observation. A typical postoperative stay after a BCC procedure is one night. During this time, you are carefully monitored for complications. Mothers are typically on modified bed rest for three weeks after the procedure.

After discharge from our Center's care, you may return to your referring doctor for ongoing care and delivery.

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