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两囊胚移植后形成的双绒毛膜三羊膜三胎妊娠减胎:两例病例报告及文献复习。

Dichorionic triamniotic triplets after two blastocysts transfer underwent multifetal pregnancy reduction: two case reports and literature review.

机构信息

Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No 218 Jixi Road, Hefei, 230022, China.

NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, China.

出版信息

BMC Womens Health. 2024 Sep 5;24(1):492. doi: 10.1186/s12905-024-03324-4.

Abstract

BACKGROUND

The increase in the rate of multiple pregnancies in clinical practice is associated with assisted reproductive technology (ART). Given the high risk of dichorionic triamniotic (DCTA) triplet pregnancies, reducing DCTA triplet pregnancies to twin or singleton pregnancies is often beneficial.

CASE PRESENTATION

This article reports on two cases of DCTA triplet pregnancies resulting from two blastocyst transfers. Given the high risk of complications such as twin-to-twin transfusion syndrome (TTTS) in monochorionic diamniotic (MCDA) twin pregnancies, patients have a strong desire to preserve the dichorionic diamniotic (DCDA) twins. Multifetal pregnancy reduction (MFPR) was performed in both cases to continue the pregnancy with DCDA twins by reducing one of the MCDA twins. Both of the pregnant women in this report eventually gave birth to healthy twins at 37 weeks.

CONCLUSIONS

For infertile couples with multiple pregnancies but with a strong desire to remain the DCDA twins, our report suggests that reducing DCTA triplets to DCDA twin pregnancies may be an option based on clinical operability and assessment of surgical difficulty.

摘要

背景

辅助生殖技术(ART)的应用导致临床实践中多胎妊娠率增加。鉴于双绒毛膜三羊膜囊(DCTA)三胎妊娠的高风险,将 DCTA 三胎妊娠减至双胎或单胎妊娠通常是有益的。

病例介绍

本文报告了两例因囊胚移植而导致的 DCTA 三胎妊娠。鉴于单绒毛膜双羊膜囊(MCDA)双胎妊娠中双胎输血综合征(TTTS)等并发症的高风险,患者强烈希望保留双绒毛膜双羊膜囊(DCDA)双胎。在这两例病例中,均通过减少其中一个 MCDA 双胎来进行多胎妊娠减少(MFPR),以继续 DCDA 双胎妊娠。本报告中的两名孕妇最终均在 37 周时分娩出健康的双胞胎。

结论

对于有多胎妊娠但强烈希望保留 DCDA 双胞胎的不孕夫妇,我们的报告表明,根据临床可行性和手术难度评估,将 DCTA 三胎妊娠减至 DCDA 双胎妊娠可能是一种选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/979a/11375843/4288cc32d3ad/12905_2024_3324_Fig1_HTML.jpg

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