Volume 13, Issue 11 (11-2015)                   IJRM 2015, 13(11): 729-732 | Back to browse issues page

XML Persian Abstract Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Talebian M, Rahimi-Sharbaf F, Shirazi M, Teimoori B, Izadi-mood N, Sarmadi S. Conjoined twins in a monochorionic triplet pregnancy after in vitro fertilization: a case report. IJRM 2015; 13 (11) :729-732
URL: http://ijrm.ir/article-1-600-en.html
Conjoined twins in a monochorionic triplet pregnancy after in vitro fertilization: a case report
Marzieh Talebian1 , Fatemeh Rahimi-Sharbaf * 2, Mahboobeh Shirazi1 , Batool Teimoori3 , Narges Izadi-mood4 , Soheila Sarmadi4
1- Department of Obstetrics and Gynecology, Women Moheb Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
2- Department of Obstetrics and Gynecology, Women Moheb Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran , rahimish@tums.ac.ir
3- Department of Obstetrics and Gynecology, Zahedan University of Medical Sciences, Zahedan, Iran
4- Department of Pathology, Women Moheb Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
Abstract:   (2841 Views)
Background: Monozygotic monochorionic triplet pregnancy with conjoined twins is a very rare condition and is associated with many complications. Case: In this study, we describe a monochorionic–diamniotic triplet pregnancy after in vitro fertilization with an intracytoplasmic sperm injection. At a gestational age of 6 weeks and 4 days of pregnancy one gestational sac was observed, and at a gestational age of 12 weeks and 2 days, triplets with conjoined twins were diagnosed. After consulting with the parents, they chose fetal reduction of the conjoined twins. Selective feticide was successfully performed by radiofrequency ablation at 16 weeks of pregnancy. Unfortunately, the day after the procedure, the membrane ruptured, and 1 week later, all fetuses and placenta were spontaneously aborted. Conclusion: Monochorionic triplet pregnancy with conjoined twins is very rare. These pregnancies are associated with very serious complications. Intra cytoplasmic sperm injection increases the rate of monozygotic twinning and conjoined twins. Counseling with parents before IVF is very important.
Keywords: Conjoined twins, Triplet pregnancy, Monochorionic-Diamniotic, Radiofrequency ablation.
Full-Text [PDF 415 kb]   (905 Downloads) |   |   Full-Text (HTML)  (387 Views)  
Type of Study: Original Article |
References
1. Garbe G, Jabamoni R. Monochorionic-triamnionic triplet pregnsncy after in vitro fertilization: a case report. Obstet Gynecol 2014; 123: 96s. [DOI:10.1097/01.AOG.0000447435.30546.62]
2. Rees AE, Vujanic GM, Williams WM. Epidemic of conjoined twins in Cardiff. Br J Obstet Gynaecol 1993; 100: 388–391. [DOI:10.1111/j.1471-0528.1993.tb12987.x]
3. Sepulveda W, Munoz H, Alcalde JL. Conjoined twins in a triplet pregnancy: early prenatal diagnosis with three-dimensional ultrasound and review of the literature. Ultrasound Obstet Gynecol 2003; 22: 199–204. [DOI:10.1002/uog.185]
4. Sellami A, Chakroun N, Frikha R, Bouayed NA, Amouri H, Rebai T. Xipho-omphalopagus conjoined twins in a spontaneous triplet pregnancy: autopsy findings. APSP J Case Rep 2013; 18: 4: 49.
5. Shevell T, Malone FD, Weintraub J, Thaker HM, D'alton ME. Radiofrequency ablation in a monochorionic twin discordant for fetal anomalies. Am J Obstet Gynecol 2004; 190: 575-576. [DOI:10.1016/j.ajog.2003.08.010]
6. Lewi L, Gratacos E, Ortibus E, Van Schoubroeck D, Carreras E, Higueras T, et al. Pregnancy and infant outcome of 80 consecutive cord coagulations in complicated monochorionic multiple pregnancies. Am J Obstet Gynecol 2006; 194: 782-789. [DOI:10.1016/j.ajog.2005.09.013]
7. Rustico MA, Baietti MG, Coviello D, Orlandi E, Nicolini U. Managing twins discordant for fetal anomaly. Prenat Diagn 2005; 25: 766-771. [DOI:10.1002/pd.1260]
8. Robyr R, Yamamoto M, Ville Y. Selective feticide in complicated monochorionic twin pregnancies using ultrasound-guided bipolar cord coagulation. BJOG 2005; 112: 1344-1348. [DOI:10.1111/j.1471-0528.2005.00746.x]
9. Tsao K, Feldstein VA, Albanese CT, Sandberg PL, Lee H, Harrison MR, et al. Selective reduction of acardiac twin by radiofrequency ablation. Am J Obstet Gynecol 2002; 187: 635-640. [DOI:10.1067/mob.2002.125242]
10. Moise KJ Jr, Johnson A, Moise KY, Nickeleit V. Radiofrequency ablation for selective reduction in the complicated monochorionic gestation. Am J Obstet Gynecol 2008; 198: 198.e1-5. [DOI:10.1016/j.ajog.2007.07.043]
11. Paramasivam G, Wimalasundera R, Wiechec M, Zhang E, Saeed F, Kumar S. Radiofrequency ablation for selective reduction in complex monochorionic pregnancies. BJOG 2010; 117: 1294-1298. [DOI:10.1111/j.1471-0528.2010.02624.x]
12. Wimalasundera RC. Selective reduction and termination of multiple pregnancies. Semin Fetal Neonatal Med 2010; 15: 327-335. [DOI:10.1016/j.siny.2010.08.002]
13. Tarlatzis BC, Qublan HS, Sanopoulou T, Zepiridis L, Grimbizis G, Bontis J. Increase in the monozygotic twinning rate after intracytoplasmic sperm injection and blastocyst stage embryo transfer. Fertil Steril 2002; 77: 196-198. [DOI:10.1016/S0015-0282(01)02958-2]
14. Abusheika N, Salha O, Sharma V, Brinsden P. Monozygotic twinning and IVF/ICSI treatment: a report of 11 cases and review of literature. Hum Reprod Update 2000; 6: 396-403. [DOI:10.1093/humupd/6.4.396]
15. Geipel A, Berg C, Katalinic A, Plath H, Hansmann M, germer U, et al. Perenatal diagnosis and obstetric outcome in triplet pregnancies in relation to chorionicity. BJOG 2005; 112: 554-558. [DOI:10.1111/j.1471-0528.2005.00627.x]
16. Shepherd LJ, Smith GN. Conjoined twins in a triplet pregnancy:a case Report. Case Rep Obstet Gynecol 2011; 2011: 235873.
17. Pajkrt E, Jauniaux E. First –trimester diagnosis of conjoined twins. Prenat Diagn 2005; 25: 820-826. [DOI:10.1002/pd.1267]
Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Designed & Developed by : Yektaweb