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体外受精后单绒毛膜三胎妊娠中的联体双胎:一例报告

Conjoined twins in a monochorionic triplet pregnancy after in vitro fertilization: a case report.

作者信息

Talebian Marzieh, Rahimi-Sharbaf Fatemeh, Shirazi Mahboobeh, Teimoori Batool, Izadi-Mood Narges, Sarmadi Soheila

机构信息

Department of Obstetrics and Gynecology, Women Moheb Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Department of Obstetrics and Gynecology, Zahedan University of Medical Sciences, Zahedan, Iran.

出版信息

Iran J Reprod Med. 2015 Nov;13(11):729-32.

Abstract

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.

摘要

背景

单绒毛膜单羊膜囊三胎妊娠合并联体双胎是一种非常罕见的情况,且伴有许多并发症。

病例

在本研究中,我们描述了一例经体外受精-卵胞浆内单精子注射后的单绒毛膜双羊膜囊三胎妊娠。妊娠6周4天时观察到一个妊娠囊,妊娠12周2天时诊断出三胎妊娠合并联体双胎。在与父母商议后,他们选择减灭联体双胎。在妊娠16周时通过射频消融成功实施了选择性减胎术。不幸的是,术后第二天胎膜破裂,1周后所有胎儿及胎盘均自然流产。

结论

单绒毛膜三胎妊娠合并联体双胎非常罕见。这些妊娠伴有非常严重的并发症。卵胞浆内单精子注射会增加单卵双胎及联体双胎的发生率。体外受精前与父母进行咨询非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be6d/4695689/d243280d1f7e/ijrm-13-729-g001.jpg

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