Triply discordant triplets: probability, management options, and risks.

摘要: The spontaneous occurrence of triplets is rare. With increased utilization "assisted reproductive technologies," multifetal gestations have become more common. empiric fetal risk for major malformation approximately 3%. In a triplet pregnancy each fetus independently carries this so that the probability having at least one malformed 9%. It much less likely to 2 or 3 simultaneously but discordantly fetuses in multizygotic gestation (.09% and .0027% risk, respectively). We report on first case, our knowledge, an ovulation-stimulated complicated by 3-way discordance malformations diagnosed late second trimester ultrasound. Fetus A was affected congenital diaphragmatic hernia trisomy 21; B had encephalocele, midline facial defect, cleft palate; C evidence unilateral claw hand otherwise normal survey. At 19 weeks gestation, found spontaneously died, selective termination performed. conclude: (1) finding single should lead extensive search all members pregnancy, (2) simultaneous than member circumstance under which multiple deserves consideration. article we discuss important issues caveats performance abnormal gestations.