METHODS: 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.
方法:我们报告一例单绒毛膜羊膜三胎妊娠,14周时的超声检查显示一对连体的胸椎胎儿,分享心,肝脏,和脐带,除了脐膨出.第三个胎儿,没有畸形,呈现与双胎对双胎输血综合征相容的早期心力衰竭的迹象。决定在18周时进行期待管理,三个胎儿发生宫内死亡。流产是通过子宫切开术进行的。
结论:讨论了这些病例的治疗方法,提出了三种管理方案:预期管理,选择性减少连体胎儿,或终止妊娠。对文献的回顾发现只有12例具有这种病理组合,其中只有3个正常胎儿(25%)存活,没有一个连体双胞胎存活。据我们所知,该病例是单绒毛膜三胎妊娠合并合并早期双胎对双胎输血的首例。