Professor Marek Lubusky, MD, PhD, MHAProfessor Marek Lubusky, MD, PhD, MHA

Sobek A. Jr., Prochazka M., Klaskova E., Zborilova B., Lubusky M., Sobek A. Triple pregnancy with mixed chorionicity following in vitro fertilization: is fetal reduction necessary? Čes. Gynek., 2017, 82 (2), s. 118-121.


Objective: The increasing incidence and management of monozygotic twinning in patients undergoing in vitro fertilization (IVF) has been the subject of much debate. Here, we describe the management and outcome of two triple pregnancies with mixed chorionicity with a monochorionic­diamniotic twin pair and a singleton following the transfer of two embryos during IVF treatment.
Design: Case report.
Setting: Department of Obstetrics and Gynaecology, Palacký University Hospital, Olomouc, Czech Republic.
Methods: This study involved Patient A (30 years of age; 0 para) and Patient B (32 years of age; I Para), both with triplets of mixed chorionicity following the transfer of two embryos during IVF treatment, and treated in The Fetal Medicine Centre, Palacky University Olomouc. Detailed counselling led to the deployment of different management strategies for each case.
Results: The monochorionic twin component of Patient A was terminated by fetal reduction in the 15th week of gestation, while the remaining single pregnancy was delivered at term without complication. Patient B opted for expectant management. However, the pregnancy was complicated by severe maternal morbidity and was terminated in the 28th week of gestation following the death of one fetus.
Conclusion: Fetal reduction should be offered as a management tool to patients carrying triplets in order to improve perinatal survival. In triplets with mixed chorionicity, the reduction of monochorionic twins is particularly advisable in preventing the additional risk posed by a shared placenta.

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Professor Marek Lubusky, MD, PhD, MHA

Department of Obstetrics and Gynecology
Palacky University Olomouc, Faculty of Medicine and Dentistry
University Hospital Olomouc
I. P. Pavlova 6, 77520 Olomouc, Czech Republic
Tel: +420 585 852 785
Mobil: +420 606 220 644

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