CC BY-NC-ND 4.0 · AJP Rep 2017; 07(02): e106-e110
DOI: 10.1055/s-0037-1603917
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Monochorionic-Triamniotic Triplet Pregnancy Complicated by Twin Reversed Arterial Perfusion Sequence: Case Report and Literature Review

Pingshan Pan
1  Department of Obstetrics, Guangxi Zhuang Autonomous Region Women and Children Health Care Hospital, Nanning, Guangxi, People's Republic of China
,
Guoyang Luo
2  Department of Obstetrics and Gynecology, University of Connecticut, Farmington, Connecticut
,
Lu Tang
1  Department of Obstetrics, Guangxi Zhuang Autonomous Region Women and Children Health Care Hospital, Nanning, Guangxi, People's Republic of China
,
Jeanne D. Rolle
2  Department of Obstetrics and Gynecology, University of Connecticut, Farmington, Connecticut
,
Yuqin Qin
1  Department of Obstetrics, Guangxi Zhuang Autonomous Region Women and Children Health Care Hospital, Nanning, Guangxi, People's Republic of China
,
Quan Zeng
1  Department of Obstetrics, Guangxi Zhuang Autonomous Region Women and Children Health Care Hospital, Nanning, Guangxi, People's Republic of China
,
Jiangting Wei
1  Department of Obstetrics, Guangxi Zhuang Autonomous Region Women and Children Health Care Hospital, Nanning, Guangxi, People's Republic of China
,
Yuanfang Chen
1  Department of Obstetrics, Guangxi Zhuang Autonomous Region Women and Children Health Care Hospital, Nanning, Guangxi, People's Republic of China
,
Hongwei Wei
1  Department of Obstetrics, Guangxi Zhuang Autonomous Region Women and Children Health Care Hospital, Nanning, Guangxi, People's Republic of China
› Author Affiliations
Further Information

Publication History

21 February 2017

21 April 2017

Publication Date:
12 June 2017 (online)

  

Abstract

Background Monochorionic-triamniotic pregnancies are rare and fraught with complications.

Case A case of monochorionic-triamniotic triplet pregnancy complicated by twin reversed arterial perfusion (TRAP) sequence is presented. The patient declined termination or selective fetal reduction. Triplet C was acardiac. At 24 weeks, triplet B developed polyhydramnios. At 30 weeks, polyhydramnios was seen in all three amniotic sacs, but without signs of fetal hydrops and with normal Doppler velocimetry measurements in the umbilical artery, middle cerebral artery, and ductus arteriosus of triplets A and B. At 322/7 weeks, the patient presented with preterm premature rupture of membranes and preterm labor. Two live male infants were delivered by cesarean delivery weighing 1,350 and 1,390 g, respectively; the acardiac fetus weighed 1,460 g. Pathology examination revealed a single placenta weighing1,250 g, with evidence of direct vascular connections between triplets A and C as well as between triplets A and B.

Conclusion Monochorionic-triamniotic triplet pregnancy with TRAP sequence is rare. Although the risk of complications is high, such pregnancies can be managed conservatively in select cases.

Ethical Approval

Guangxi Zhuang Autonomous Region Women and Children Care Hospital Ethics Committee approved the publication of this article.