{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,11,18]],"date-time":"2023-11-18T08:32:29Z","timestamp":1700296349481},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2005,6,7]],"date-time":"2005-06-07T00:00:00Z","timestamp":1118102400000},"content-version":"vor","delay-in-days":4632,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am. J. Med. Genet."],"published-print":{"date-parts":[[1992,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The spontaneous occurrence of triplets is rare. With increased utilization of \u201cassisted reproductive technologies,\u201d multifetal gestations have become more common. The empiric fetal risk for major malformation is \u223c 3%. In a triplet pregnancy each fetus independently carries this risk so that the probability of having at least one malformed fetus is \u223c 9%. It is much less likely to have 2 or 3 simultaneously but discordantly malformed fetuses in a multizygotic triplet gestation (.09% and .0027% risk, respectively). We report on the first case, to our knowledge, of an ovulation\u2010stimulated triplet pregnancy complicated by 3\u2010way discordance for major malformations diagnosed in the late second trimester by ultrasound. Fetus A was affected by congenital diaphragmatic hernia and trisomy 21; fetus B had encephalocele, a midline facial defect, and a cleft palate; and fetus C had evidence of unilateral claw hand but an otherwise normal fetal survey. At 19 weeks of gestation, fetus A was found to have spontaneously died, and a selective termination of triplet B was performed. We conclude: (1) the finding of a single major malformation in one fetus should lead to extensive search for malformations in all members of the pregnancy, and (2) the simultaneous occurrence of major malformations in more than one member of a multifetal gestation is a circumstance under which multiple selective termination deserves consideration. In this article we discuss important issues and caveats in the performance of selective termination for abnormal members of multifetal gestations. \u00a9 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/ajmg.1320440318","type":"journal-article","created":{"date-parts":[[2005,6,11]],"date-time":"2005-06-11T16:21:52Z","timestamp":1118506912000},"page":"361-364","source":"Crossref","is-referenced-by-count":1,"title":["Triply discordant triplets: Probability, management options, and risks"],"prefix":"10.1002","volume":"44","author":[{"given":"Peter G.","family":"Pryde","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nelson B.","family":"Isada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark P.","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Howard","family":"Grundy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark I.","family":"Evans","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2005,6,7]]},"reference":[{"key":"e_1_2_1_2_1","unstructured":"ACOG Tech Bull. #120(1988): Medical induction of ovulation."},{"key":"e_1_2_1_3_1","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/S0306-3356(21)00586-0","article-title":"The prenatal diagnosis of fetal structural anomalies by ultrasound","volume":"10","author":"Campbell S","year":"1983","journal-title":"Clin Obstet Gynaecol"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1879-3479.1977.tb00671.x"},{"key":"e_1_2_1_5_1","first-page":"690","article-title":"Selective second\u2010trimester termination of the anomalous fetus in twin pregnancies","volume":"73","author":"Chitkara U","year":"1989","journal-title":"Obstet Gynecol"},{"key":"e_1_2_1_6_1","first-page":"321","article-title":"Perinatal mortality in twins, Australia, 1973\u20131980: II. Maternal age, lethal congenital malformations and sex","volume":"37","author":"Doherty JDH","year":"1988","journal-title":"Acta Genet Med Gemellol"},{"key":"e_1_2_1_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(89)90852-1"},{"key":"e_1_2_1_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.1320310211"},{"key":"e_1_2_1_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0004.1979.tb00846.x"},{"key":"e_1_2_1_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006254-198903000-00003"},{"key":"e_1_2_1_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000263545"},{"key":"e_1_2_1_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1988.tb06599.x"},{"key":"e_1_2_1_13_1","first-page":"1037","article-title":"Calculated risk of chromosomal abnormalities in twin gestations","volume":"76","author":"Rodis JF","year":"1990","journal-title":"Obstet Gynecol"},{"key":"e_1_2_1_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(16)45308-2"},{"key":"e_1_2_1_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(79)80278-4"},{"key":"e_1_2_1_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.1320290320"},{"key":"e_1_2_1_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(90)90550-O"}],"container-title":["American Journal of Medical Genetics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fajmg.1320440318","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajmg.1320440318","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,24]],"date-time":"2023-10-24T01:40:44Z","timestamp":1698111644000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajmg.1320440318"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1992,10]]},"references-count":16,"journal-issue":{"issue":"3","published-print":{"date-parts":[[1992,10]]}},"alternative-id":["10.1002\/ajmg.1320440318"],"URL":"https:\/\/doi.org\/10.1002\/ajmg.1320440318","archive":["Portico"],"relation":{},"ISSN":["0148-7299","1096-8628"],"issn-type":[{"value":"0148-7299","type":"print"},{"value":"1096-8628","type":"electronic"}],"subject":[],"published":{"date-parts":[[1992,10]]}}}