Monochorionic triplet pregnancy complicated by conjoined twins and early twin-twin transfusion syndrome.

Autor: Bustos JC; Department of Obstetrics and Gynecology, San Juan de Dios Hospital, University of Chile, Chile.; Maternal-Fetal Medicine Unit, San Juan de Dios Hospital, Santiago, Chile., Vera H; Department of Obstetrics and Gynecology, San Juan de Dios Hospital, University of Chile, Chile.; Maternal-Fetal Medicine Unit, San Juan de Dios Hospital, Santiago, Chile., Ahumada P; Department of Obstetrics and Gynecology, San Juan de Dios Hospital, University of Chile, Chile.; Maternal-Fetal Medicine Unit, San Juan de Dios Hospital, Santiago, Chile., Martin D; Maternal-Fetal Medicine Unit, San Juan de Dios Hospital, Santiago, Chile.
Jazyk: angličtina
Zdroj: Birth defects research [Birth Defects Res] 2024 Feb; Vol. 116 (2), pp. e2317.
DOI: 10.1002/bdr2.2317
Abstrakt: Background: The condition of monozygotic, monochorionic triplet fetuses with a pair of conjoined twins is extremely rare (close to one in a million births), presents challenges in its management, and with poor prognosis.
Case Report: We report a case of monochorionic diamniotic triplet pregnancy, ultrasound at 14 weeks shows a pair of conjoined thoracopagus fetuses, sharing heart, liver, and umbilical cord, in addition to omphalocele. The third fetus, without malformations, presents signs of early heart failure compatible with twin-to-twin transfusion syndrome. It was decided to carry out expectant management where at 18 weeks, intrauterine death of the three fetuses occurs. An abortion is performed by hysterotomy.
Conclusions: The treatment in these cases is discussed, three management options have been proposed: expectant management, selective reduction of the conjoined fetuses, or termination of the pregnancy. A review of the literature found only 12 cases with this combination of pathologies, in which only 3 normal fetuses (25%) survived and none of the conjoined twins survived. To our knowledge, this case is the first of a monochorionic triplet pregnancy with conjoined fetuses complicated with early twin-to-twin transfusion.
(© 2024 Wiley Periodicals LLC.)
Databáze: MEDLINE
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