%0 Review
%T Monochorionic triplet pregnancy complicated by conjoined twins and early twin-twin transfusion syndrome.
%A Bustos JC
%A Vera H
%A Ahumada P
%A Martin D
%J Birth Defects Res
%V 116
%N 2
%D 2024 Feb
%M 38362599
暂无%R 10.1002/bdr2.2317
%X <B>BACKGROUND: </B>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.<BR><B>METHODS: </B>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.<BR><B>CONCLUSIONS: </B>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.