scholarly journals Conjoined twins in dichorionic diamniotic triplet pregnancy: a report of three cases and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hongyan Liu ◽  
Chunyan Deng ◽  
Qing Hu ◽  
Hua Liao ◽  
Xiaodong Wang ◽  
...  
Keyword(s):  
Perinatal Outcomes ◽  
Selective Reduction ◽  
Good Health ◽  
Conjoined Twins ◽  
Multidisciplinary Teams ◽  
Triplet Pregnancy ◽  
Management Options ◽  
Monochorionic Twins ◽  
Healthy Female ◽  
Female Baby

Abstract Background Conjoined twins are a rare and serious complication of monochorionic twins. The total incidence is 1.5 per 100,000 births, and about 50% are liveborn. Prenatal screening and diagnosis of conjoined twins is usually performed by ultrasonography. Magnetic resonance imaging can be used to assist in the diagnosis if necessary. Conjoined twins in dichorionic diamniotic triplet pregnancy are extremely rare. Case presentation We reported three cases of dichorionic diamniotic triplet pregnancy with conjoined twins. Due to the poor prognosis of conjoined twins evaluated by multidisciplinary teams, selective termination of conjoined twins was performed in three cases. In case 1, selective reduction of the conjoined twins was performed at 16 gestational weeks, and a healthy female baby weighing 3270 g was delivered at 37 weeks. In case 2, the conjoined twins were selectively terminated at 17 weeks of gestation, and a healthy female baby weighing 2760 g was delivered at 37 weeks and 4 days. In case 3, the conjoined twins were selectively terminated at 15 weeks and 2 days, and a healthy female baby weighing 2450 g was delivered at 33 weeks and 6 days. The babies of all three cases were followed up and are in good health. Conclusion(s) Surgical separation is the only treatment for conjoined twins after birth. Early determination of chorionicity and antenatal diagnosis of conjoined twins in triplet gestations are critical for individualized management options and the prognosis of normal triplets. Expecting parents should be extensively counseled by multidisciplinary teams. If there are limitations in successful separation after birth, early selective termination of the conjoined twins by intrathoracic injection of potassium chloride may be a procedure in dichorionic diamniotic triplet pregnancy to improve perinatal outcomes of the normal triplet.

scholarly journals P05.13: Selective reduction of conjoined twins at 13 weeks of a triplet pregnancy

2006 ◽  
Vol 28 (4) ◽  
pp. 562-562
Author(s):  
L. C. S. Bussamra ◽  
F. M. Andrade ◽  
C. G. V. Murta ◽  
P. Cossi ◽  
M. M. Barbosa ◽  
...  
Keyword(s):  
Selective Reduction ◽  
Conjoined Twins ◽  
Triplet Pregnancy

scholarly journals Radiofrequency ablation for selective fetal reduction in complicated Monochorionic twins; comparing the outcomes according to the indications

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fatemeh Rahimi-Sharbaf ◽  
Marjan Ghaemi ◽  
Ahmed A. Nassr ◽  
Alireza A. Shamshirsaz ◽  
Mahboobeh Shirazi
Keyword(s):  
Radiofrequency Ablation ◽  
Gestational Age ◽  
Perinatal Outcomes ◽  
Selective Reduction ◽  
Success Rates ◽  
Maternal Complications ◽  
Monochorionic Twins ◽  
Arterial Perfusion ◽  
Fetal Reduction ◽  
The Mean

Abstract Background To evaluate the perinatal outcomes in women with complicated monochorionic diamniotic twins who underwent selective reduction using radiofrequency ablation (RFA). Methods This retrospective study included patients with complicated monochorionic diamniotic twins between 16 to 28 weeks who underwent selective reduction using RFA. Results During the study period, 143 women with complicated monochorionic twins underwent RFA including 52 with selective fetal growth restriction (sFGR), 48 with twin to twin transfusion syndrome (TTTS), 33 with major fetal anomalies in one of the twins, and 10 with reversed arterial perfusion sequence (TRAP). The overall survival was 71.3% (102/143). The procedures were technically successful in achieving selective termination in all cases. The mean ± SD of gestational age at the time of the procedure was 21.0 ± 2.3 weeks. The mean ± SD of gestational age at delivery was 34.6 ± 3.3 weeks. The mean ± SD of overall procedure-to-delivery time was 12 ± 1.7 weeks. The pregnancy success rates among sFGR, TRAP, TTTS and anomaly groups were 82.7, 80, 73 and 60.7% respectively. There were no maternal complications. Conclusion Radiofrequency ablation for fetal reduction in complicated monochorionic twin pregnancies appears to be a reasonable option. The pregnancy success rate following RFA selective reduction was highest among sFGR and TRAP groups and lowest in the anomaly group.

scholarly journals Conjoined Twins in a Triplet Pregnancy: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Lynn J. Shepherd ◽  
Graeme N. Smith
Keyword(s):  
Case Report ◽  
Perinatal Mortality ◽  
3D Imaging ◽  
Pregnancy Termination ◽  
Rare Complication ◽  
3D Ultrasound ◽  
Conjoined Twins ◽  
Triplet Pregnancy ◽  
Management Options ◽  
Monozygotic Twinning

Background. Conjoined twins are a rare complication of monozygotic twinning and are associated with high perinatal mortality.Case. Here we present a case of conjoined twins in a triplet pregnancy diagnosed at 13 of weeks gestation. With the aid of 3D ultrasound and MRI images, the parents were counseled regarding the management options, including continuation of pregnancy, termination of pregnancy, or selective fetocide. They chose selective fetocide of the conjoined twins and went on to deliver the remaining triplet at term.Conclusion. This case represents to our knowledge the only MRI images of conjoined twins in a triplet pregnancy and demonstrates how 3D imaging can be used to better counsel patients about management options.

scholarly journals Intrafetal laser therapy in a monochorionic diamniotic triplet pregnancy with two acardiac fetuses: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Guiqiong Huang ◽  
Hua Liao ◽  
Qing Hu ◽  
Xiaodong Wang ◽  
Haiyan Yu
Keyword(s):  
Laser Therapy ◽  
Fetal Echocardiography ◽  
Good Health ◽  
Triplet Pregnancy ◽  
Fetal Ultrasonography ◽  
Arterial Perfusion ◽  
Female Baby ◽  
Individualized Management ◽  
Clinical Conditions ◽  
Twin Reversed Arterial Perfusion

Abstract Background Monochorionic diamniotic triplet pregnancies are rare. Twin reversed arterial perfusion sequence in monochorionic triplet pregnancies is extremely rare, and it is associated with high perinatal morbidity and mortality rates in the “pump fetus.” Case presentation We reported a case of monochorionic diamniotic triplet pregnancy with twin reversed arterial perfusion sequence, including two acardiac fetuses sharing a single amniotic sac and a normal fetus in another amniotic sac. Due to rapid growth of the acardiac fetuses, intrafetal laser therapy was performed in both of them under ultrasound guidance at 15 weeks +5 days. Subsequently, regular and careful antenatal care including fetal ultrasonography and doppler and fetal echocardiography was conducted. At 37 weeks +4 days, a healthy female baby weighing 2510 g was delivered. The baby was followed up and now at 11 months old is in good health. Conclusions Twin reversed arterial perfusion sequence in monochorionic triplet pregnancy should be diagnosed early by ultrasound imaging during pregnancy. Individualized management should be based on clinical conditions to improve the perinatal outcome of the pump twin. Intrafetal laser therapy could be an alternative procedure when intrauterine intervention is required.

Perinatal Outcome of Monochorionic Twins With Selective IUGR Compared With Uncomplicated Monochorionic Twins

2011 ◽  
Vol 14 (5) ◽  
pp. 457-462 ◽  
Author(s):  
Boaz Weisz ◽  
Liat Hogen ◽  
Yoav Yinon ◽  
Liat Gindes ◽  
Alon Shrim ◽  
...  
Keyword(s):  
Perinatal Outcome ◽  
Umbilical Artery ◽  
Perinatal Outcomes ◽  
Monochorionic Twins ◽  
Group A ◽  
Umbilical Artery Doppler ◽  
Group B ◽  
A Prospective Study ◽  
Gestational Age At Birth ◽  
Twin Pregnancies

Objective: To evaluate the perinatal outcome of MC twins with selective IUGR (sIUGR).Study design: A prospective study, which included three groups of MC twins: Group A, uncomplicated MC twin pregnancies (n = 91); group B, sIUGR with normal umbilical artery Doppler (n = 19); and group C, sIUGR with abnormal (absence or reversed EDV) umbilical artery Doppler (n = 18). The latter were routinely hospitalized in the high-risk ward under strict surveillance.Results: Neonatal outcome of fetuses complicated with sIUGR and normal Doppler was similar to controls. Neonates born to pregnancies complicated by sIUGR and abnormal Doppler had significantly increased incidence of CNS findings, RDS, NEC, sepsis, and neonatal death compared to controls. Adverse outcome in this group was independently associated only with gestational age at birth.Conclusion: The perinatal outcomes of MC twins complicated with sIUGR and normal Doppler are similar to uncomplicated MC pregnancies. MC twins with sIUGR and abnormal Doppler have reasonable outcomes, yet significantly more neonatal complications compared to non-complicated MC twins.

scholarly journals Successful management of a triplet heterotropic caesarean scar pregnancy in spontaneous conception

2019 ◽  
Vol 8 (9) ◽  
pp. 3808
Author(s):  
Nilofar Imamhusen Yelurkar ◽  
Dharam Jatin Shah ◽  
Meena Naresh Satia ◽  
Vijaya Rajesh Badhwar
Keyword(s):  
Previous Cesarean Section ◽  
Successful Management ◽  
Lower Segment ◽  
Triplet Pregnancy ◽  
Management Options ◽  
Surgical Interventions ◽  
Uncommon Presentation ◽  
Laparoscopic Excision ◽  
Medical Line ◽  
Previous Cesarean

A cesarean scar ectopic pregnancy -CSEP is a fairly uncommon presentation wherein the conceptus is implanted at the exact scar site of the previous cesarean section deep in the myometrium. Given the relatively rare incidence of CSEP establishing a diagnosis of CSEP can be challenging current standards of therapy have been derived from data obtained from a limited number of patient’s management options for CSEP range from medical line of treatment to surgical interventions such as sonography guided injections to laparoscopic excision or laparotomy or combination of these modalities. Herein we report a rare case of triplet pregnancy with one gestation sac implanted at the site of lower segment scar diagnosed on transvaginal ultrasonography along with MRI who was managed successfully with systemic methotrexate.

Perinatal outcome of dichorionic-triamniotic as compared to trichorionic triplets

2016 ◽  
Vol 44 (8) ◽  
Author(s):  
Teresinha Simões ◽  
Alexandra Queiros ◽  
Margarida Rosal Gonçalves ◽  
Isabel Periquito ◽  
Patricia Silva ◽  
...  
Keyword(s):  
Univariate Analysis ◽  
Perinatal Outcomes ◽  
Neonatal Morbidity ◽  
Mortality Rates ◽  
Extremely Low Birth Weight ◽  
Triplet Pregnancy ◽  
Maternal Characteristics ◽  
Early Neonatal Mortality ◽  
Spontaneous Conception ◽  
Similar Incidence

AbstractObjective:To evaluate if the perinatal outcomes of dichorionic-triamniotic (DC) triplets are significantly different than that of trichorionic (TC) triplets.Study design:Comparison of maternal and neonatal data of 44 DC to 46 TC triplets, using univariate analysis.Results:DC triplets were significantly more common after spontaneous conception but all other maternal characteristics as well complications and cesarean section rates were similar. Both groups had similar incidence of birth at <32 and <28 weeks as well as similar incidence of very low and extremely low birth weight. There was similar incidence of neonatal morbidity except for twin-twin transfusion syndrome (13.6%) in the DC group. The stillbirth rate was 45/1000 and 29/1000, the early neonatal mortality rates were 63/1000 and 45/1000, and the perinatal mortality rate was 106/1000 and 72/1000 for DC and TC triplets, respectively (all not significantly different).Conclusions:Our data indicate that DC twins are not significantly disadvantaged compared to TC triplets and the similar outcomes might be reassuring for those who consider continuing their DC triplet pregnancy.

612: Spontaneous and iatrogenic twin anemia polycythemia sequence (TAPS) in monochorionic twins without oligo-polyhydramnios sequence: Management options in a 'new' disease

2008 ◽  
Vol 199 (6) ◽  
pp. S176
Author(s):  
Femke Slaghekke ◽  
Enrico Lopriore ◽  
Frans Klumper ◽  
Frank Vandenbussche ◽  
Annemieke Middeldorp ◽  
...  
Keyword(s):  
New Disease ◽  
Management Options ◽  
Monochorionic Twins

Conjoined Twins with Thoracoabdominopagus Anomaly in the Third Trimester

2014 ◽  
Vol 6 (3) ◽  
pp. 191-194
Author(s):  
G Saranya ◽  
Jaya Vijayaraghavan ◽  
Bhuvana LNU ◽  
Sheela LNU
Keyword(s):  
South Asian ◽  
Cardiopulmonary Arrest ◽  
Conjoined Twins ◽  
Rare Occurrence ◽  
Review Of The Literature ◽  
Resonance Imaging ◽  
Third Trimester ◽  
Monochorionic Twins ◽  
The Third ◽  
Surgical Separation

ABSTRACT Conjoined twinning is rare; occurrence is about 1% of monochorionic twins. Here, we report a case of 26-year-old multigravida with 29 weeks pregnancy with conjoined twinsthoracoabdominopagus. Two live female babies joined at the chest and abdomen were delivered by cesarean section. The parents refused a separation operation and despite resuscitation the twins died of cardiopulmonary arrest after 16 hours. A review of the literature suggests that early diagnosis by a combination of ultrasound and magnetic resonance imaging is essential for predicting prognosis, management and success of surgical separation. It offers an opportunity for early counseling for parents and option for termination. How to cite this article Saranya G, Vijayaraghavan J, Bhuvana, Sheela. Conjoined Twins with Thoracoabdominopagus Anomaly in the Third Trimester. J South Asian Feder Obst Gynae 2014;6(3):191-194.

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