We report a rare case of triplet pregnancy with one intrauterine fetal death and one fetus papyraceus.
The patient was a 26-year-old secundipara, who had been treated for infertility with clomiphene-hMG-hCG therapy. In 9 weeks of pregnancy, three gestational sacs were identified in the uterine cavity by ultrasonography, but one sac was without fetus. At the 23rd week of pregnancy, she was referred to our hospital for intrauterine death of two fetus.
Considering that the pregnancy was trizygotic and there was no vascular anastomoses in the placenta, we decided to continue her pregnancy until the remaining one fetus became viable. During the course of pregnancy, we were constantly on guard against dead fetus syndrome. The level of serum FDP was transiently elevated during the 29 week of pregnancy, but returned to normal with no treatment. In the 36th week of pregnancy, cesarean section was performed, and a female baby was delivered. Her birth-weight was 2365g and the Apgar score was 9 at 1 minute of life. In addition to the baby, a parchment-like fetus and the placenta of another fetus were removed. The child has grown with no problem.
In this case, the information about the zygocity of the triplets in early pregnancy was useful in decision for the treatment. [Adv Obstet Gynecol 46 (1); 14-17, 1994 (H6.1)]
