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Monoamniotic twins in a triplet gestation with favorable outcome
H Harirah1, S E Donia, D C Jones
1Department of Obstetrics and Gynecology, University of Texas Medical Branch, Division of Maternal-Fetal Medicine, Galveston, Texas, USA.
Background:
Monoamniotic twins in a triplet gestation is a rare combination. Each condition is separately associated with significant perinatal morbidity and mortality. There are no data about the outcome and management of such gestations.
Case:
We report a case of monoamniotic twins in a spontaneous dichorionic triplet gestation with a favorable outcome. Transvaginal ultrasound examination at nine weeks confirmed the diagnosis. Close follow-up was established that included continuous fetal monitoring after 30 weeks. At 35 weeks and after confirming fetal lung maturity, elective cesarean delivery was performed resulting in three liveborn female infants.
Conclusion:
Favorable outcome of such a rare coexistence of monoamniotic twins in a triplet gestation is possible. Vigilant fetal monitoring and timed delivery remain the mainstays of management.