title: Incidences of Feto-Fetal Transfusion Syndrome and Perinatal Outcomes in Triplet Gestations with Monochorionic Placentation.
abstract: BACKGROUND
  This study aimed to determine the incidences of feto-fetal transfusion syndrome (FFTS) and perinatal outcomes in triplet gestations with monochorionic placentation.
  
  
  METHODS
  In this retrospective cohort study, we evaluated the incidences of FFTS and perinatal outcomes at 28 days of age in cases of triplet gestations with monochorionic placentation who visited our centers before 16 weeks of gestation and delivered over a period of 11 years.
  
  
  RESULTS
  In 41 triplet gestations (17 monochorionic triamniotic, 22 dichorionic triamniotic, 1 dichorionic diamniotic, and 1 monochorionic monoamniotic), the incidence of FFTS was 17.1%, and the median gestational age at FFTS diagnosis was 19 weeks. In 123 triplets, the incidences of fetal death and neonatal death at 28 days of age were 8.1 and 0.9%, respectively. None of the surviving infants had grade 3 or 4 intraventricular hemorrhage, while cystic periventricular leukomalacia occurred in 6 of 113 infants (5.3%). The incidence of poor outcomes (death or any major neurological complication at 28 days of age) was 13.8%.
  
  
  CONCLUSIONS
  Seventeen percent of triplet pregnancies with monochorionic placentation developed FFTS, and 14% had a poor outcome. Therefore, triplet gestations with monochorionic placentation should be followed carefully.
authors.affiliation: Department of Maternal Fetal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Sato
authors.forename: Keisuke
authors.initials: K
authors.lastname: Ishii
authors.forename: Tae
authors.initials: T
authors.lastname: Yokouchi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Murakoshi
authors.forename: Kenji
authors.initials: K
authors.lastname: Kiyoshi
authors.forename: Soichiro
authors.initials: S
authors.lastname: Nakayama
authors.forename: Naoto
authors.initials: N
authors.lastname: Yonetani
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Mitsuda
mesh_terms: D000328:Adult; D002823:Chorion / Q000098:blood supply / Q000473:pathology; D005260:Female; D005330:Fetofetal Transfusion / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery; D006801:Humans; D010920:Placenta / Q000098:blood supply; D011247:Pregnancy; D059286:Pregnancy, Triplet; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome