Monochorionic diamniotic triplet pregnancy with prenatal diagnosis of cord entanglement

Monozygotic monochorionic triplet pregnancies in which triplets share an amniotic cavity (di- or monoamniotic) are very rare. In addition to the other risks of high-order multiple pregnancy, such triplets are at risk for cord entanglement and therefore cord accident and intrauterine demise.

A 32-year-old primigravid woman was found on ultrasound at 25 to 26 weeks' gestation to have a monochorionic diamniotic triplet pregnancy, a short dilated cervix, one fetus with biometry < 10th centile, and cord entanglement. The woman was hospitalized, ultrasound assessment was performed three times per week, and elective Caesarean section was performed at 30 weeks. The triplets subsequently did well.

Monochorionic diamniotic triplet pregnancy with cord entanglement can be successfully managed by admission, close inpatient monitoring, and elective delivery.