连体双胞胎
怀孕
单绒毛双胞胎
产科
医学
胎儿
生物
遗传学
作者
Juan Carlos Bustos,Héctor Gerardo Caballero Vera,Paz Ahumada,Daniel Martín
出处
期刊:Teratology
[Wiley]
日期:2024-02-01
卷期号:116 (2)
摘要
Abstract 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.
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