Evidence of early placental vascular anastomosis during selective embryo reduction in monozygotic twins.
OBJECTIVE
To describe selective embryo reduction of two triplet pregnancies with a monozygotic twin.


METHODS
Case reports.


METHODS
Infertility unit of a Department of Obstetrics and Gynecology.


METHODS
Two patients treated with IVF-ET who had triplet pregnancies.


METHODS
Selective embryo reduction of monozygotic twins.


METHODS
Fetal heart beat.


RESULTS
During intracardiac injection of potassium chloride plus midazolam in one of the monozygotic twin fetuses, we observed an immediate diminution of the cardiac pulse rate of the second twin. This phenomenon was observed in both patients.


CONCLUSIONS
These observations clearly indicate the presence of vascular anastomosis between the two fetuses of these monozygotic twins. Thus, use of toxic substance to reduce one of the two fetuses of a monozygotic twin pregnancy is contraindicated. In cases of triplets that include a monozygotic twin, it is safest to interrupt the evolution of the twin if selective reduction is desired.
Olivennes
François
F
Service de Gynécologie-Obstétrique, Hôpital Antoine Béclère, Clamart, France.
Doumerc
Severin
S
Senat
Marie Victoire
MV
Audibert
François
F
Fanchin
Renato
R
Frydman
René
R
D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006340:Heart Rate, Fetal / Q000502:physiology; D006801:Humans; D010920:Placenta / Q000098:blood supply*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control; D018607:Pregnancy Reduction, Multifetal / Q000379:methods*; D014310:Triplets; D014430:Twins, Monozygotic