Spontaneous Monochorionic Triamniotic Triplet Pregnancy: A Case Report

Background: Monochorionic triamniotic (MCTA) triplet pregnancy is a rare entity associated with a high risk of complications. In most previously reported cases, the pregnancy was conceived with the use of assisted reproductive technologies, and these cases were associated with complications. Case Presentation: We report a 28-year-old woman with a spontaneously conceived MCTA triplet pregnancy diagnosed at the gestational age of 26 weeks. All fetuses had normal amniotic fluid and umbilical artery Doppler findings were normal. The estimated weight of fetuses was 848 g, 891 g, and 1 kg, respectively. The patient was managed conservatively with a plan to monitor fetal growth every two weeks and a Doppler study twice weekly. On the 8th day of admission, the patient developed labor pains. Per vaginal examination revealed 1 - 2 cm cervical dilatation. Cesarean section was performed, and three girls were delivered with a single placenta (birth weight: 820, 925, and 960 g, respectively). Conclusion: Monochorionic triplet pregnancy is associated with a higher risk of fetal morbidity and mortality. Therefore, awareness of its complications can facilitate better management of such cases.

Successful Pregnancy and Delivery after Multifetal Pregnancy Reduction in A Woman with Monochorionic Triplet Pregnancy Following Intracytoplasmic Sperm Injection and the Transfer of Frozen-thawed Embryos

This was the first report of multifetal pregnancy reduction （MFPR） with mono- chorionic triplet pregnancy following ICSI and the transfer of frozen-thawed embryos. A 30-year-old woman who had undergone ICSI and the transfer of frozen-thawed embryos subsequently developed monochorionic triplet pregnancy. She did a multifetal pregnancy reduction to remove one embryo limb from the fetal sac and remained a singleton pregnancy after pregnancy reduction. At last she delivered a healthy baby girl at 40 weeks of gestation. In conclusions, an early stage fetal reduction, selection of the appropriate reduction week, and the expertise of a highly experienced doctor using ultrasound can ensure a wonderful pregnancy outcome in monozygotic multiple pregnancies.

Intrauterine fetal death in triplet gestation caused by feto-fetal transfusion syndrome–a case report

Feto-fetal transfusion syndrome(FFTS)severely affects monochorionic(MC)multiple pregnancies and affects 1 in 1600 pregnancies overall.The number of increasing disputed obstetrics cases in China is related to unavailability of prompt diagnosis of FFTS.We present here a woman with a MC triplet pregnancy with intrauterine fetal death at 33 weeks of gestation due to FFTS.Subsequent pathological anatomy showed that the MC placenta contained vascular anastomoses,including arterio-arterial anastomosis and arterio-venous anastomosis.These anastomoses led to unidirectional blood flow with the absence of adequate compensatory counter-transfusion and bi-directional flow.When encountering such challenging conditions,medical practitioners should discreetly compare the fetuses’characteristics with features of placental blood vessels and consult morphological and pathological findings.Furthermore,they should perform ultrasound examinations,particularly focussing on fetal size differences and the maximum vertical pocket in the diagnosis of FFTS,especially in MC multiple pregnancies with abdominal symptoms.