title: Monoamniotic twins in a triplet gestation with favorable outcome.
abstract: BACKGROUND
  Monoamniotic twins in a triplet gestation is a rare combination. Each condition is separately associated with significant perinatal morbidity and mortality. There are no data about the outcome and management of such gestations.
  
  
  METHODS
  We report a case of monoamniotic twins in a spontaneous dichorionic triplet gestation with a favorable outcome. Transvaginal ultrasound examination at nine weeks confirmed the diagnosis. Close follow-up was established that included continuous fetal monitoring after 30 weeks. At 35 weeks and after confirming fetal lung maturity, elective cesarean delivery was performed resulting in three liveborn female infants.
  
  
  CONCLUSIONS
  Favorable outcome of such a rare coexistence of monoamniotic twins in a triplet gestation is possible. Vigilant fetal monitoring and timed delivery remain the mainstays of management.
authors.affiliation: Department of Obstetrics and Gynecology, University of Texas Medical Branch, Division of Maternal-Fetal Medicine, Galveston, Texas, USA.
authors.forename: H
authors.initials: H
authors.lastname: Harirah
authors.forename: S E
authors.initials: SE
authors.lastname: Donia
authors.forename: D C
authors.initials: DC
authors.lastname: Jones
authors.forename: C D
authors.initials: CD
authors.lastname: Hsu
mesh_terms: D000328:Adult; D000650:Amnion / Q000000981:diagnostic imaging*; D002585:Cesarean Section; D002823:Chorion / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging*; D011272:Pregnancy, Multiple / Q000502:physiology; D014310:Triplets; D014430:Twins, Monozygotic; D016216:Ultrasonography, Prenatal