Perinatology.  2018 Dec;29(4):180-184. 10.14734/PN.2018.29.4.180.

Monochorionic Triamniotic Triplet Pregnancy Following Assisted Reproductive Technology and Radiofrequency Ablation for Selective Reduction

• Lee JH
• Oh SH
• Hong AR
• Jeong YJ
• Cho SN
• Cho DH

• KMID: 2430222
• DOI: http://doi.org/10.14734/PN.2018.29.4.180

Abstract

In assisted reproductive techniques, monozygotic twinning is not influenced by the trial of reducing the number of embryos transferred. We present extremely rare case of monochorionic triamniotic triplet pregnancy following in vitro fertilization and two-embryo transfer. During the first trimester, the crucial ultrasound findings of monochorionic triamniotic triplet pregnancy are three distinct amniotic sacs forming a triangle or ipsilon zone within a single chorionic cavity. After prudential counseling about the potential risk of a monochorionic triamniotic triplet pregnancy with the patient, selective reduction of two fetuses via radiofrequency ablation was performed. We report a case of selective reduction for monochorionic triamniotic triplet pregnancy using radiofrequency ablation at 12 weeks' gestation and obstetric progression after radiofrequency ablation was uneventful until 20 weeks' gestation.

Keyword

Triplets; Fertilization in vitro; Radiofrequency ablation

MeSH Terms

Catheter Ablation*
Chorion
Counseling
Embryonic Structures
Female
Fertilization in Vitro
Fetus
Humans
Pregnancy
Pregnancy Trimester, First
Pregnancy, Triplet*
Reproductive Techniques, Assisted*
Triplets*
Twinning, Monozygotic
Twins, Monozygotic
Ultrasonography

Figure

• 

  Fig. 1 (A) Transvaginal ultrasound performed at 8+5 weeks' gestation reveals a single intrauterine chorionic cavity with three distinct amniotic sacs (arrows) forming a triangle. (B) Three separate embryos with their own yolk sacs (asterisks) at 8+5 weeks' gestation. Note that only two yolk sacs are seen in this image. (C) Transvaginal three-dimensional ultrasound shows three apparent fetuses in a single gestational sac at 12+1 weeks' gestation.

• 

  Fig. 2 Real-time transabdominal ultrasound shows the radiofrequency ablation (RFA) needle with its prong inserted into the fetal heart.

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