Over the past 3 years, 29 operations laser coagulation operations of placental anastomoses have been performed in cases of selective growth restriction of one fetus from monochorionic twins. Indications for laser coagulation of placental anastomoses were: impaired uteroplacental blood flow type II (A and B) - III according to Gratagos in the smaller fetus, estimated mass of the smaller fetus less than the 10th percentile, mass dissociation greater than 40%. 16 monochorionic twins had IUGR type II A, 11 - IUGR type II B, 4 - type III. The effectiveness of laser coagulation of placental anastomoses in IUGR is 86.2%: two fetuses survived in 48% (12).

In 13.8% (4), premature rupture of membranes was recorded in the first week after laser coagulation of placental anastomoses

Conclusion: Laser coagulation of placental anastomoses may be an effective method in the most severe cases of selective fetal growth restriction from monochorionic twins, when an adverse outcome is expected at the very preterm stage, especially among patients who refuse the option of selective termination of pregnancy.

Natalia Kosovtsova received her medical degree at the age of 50 at the Federal State Budgetary Institution Research Institute of Obstetrics and Malignancy of the Ministry of Health of the Russian Federation. She is the head of the scientific department of radiation research methods and heads the fetal surgery group of the institute. She has 127 publications that have been cited more than 400 times, and her Hirsch index for publications is 9. She is a member of the scientific and dissertation council. She is a professor at the Department of Medical Biochemistry and Biophysics of the Ural Federal University and the Department of Obstetrics and Gynecology of the Institute of Medical Education of the Almazov Center.