Department of Gynecology, Félix Guyon'Hospital, 97400 Saint-Denis, Ile de la Réunion, France. Tél : 0262 90 55 22. Fax : 0262 90 77 30

This 35-year-old primigravida, who had undergone in-vitro-fertilization with two-embryonic transfer, came to our department at 13th, 22nd and 33rd week of pregnancy. We discovered a triplet pregnancy (one monochorial monoamniotic fetus and two monochorial biamniotic fetuses). The first and second ultrasound screening were normal. At 33-week of pregnancy the patient was admitted to our hospital due to premature uterine contractions with cervical dilatation at 3 cm. The ultrasound investigation revealed intrauterine growth restriction one of the monochorial monoamniotic fetus with an anechogenic structure near stomach ("double bubble signâ€). The other two fetuses were normal.
Two days after patient's admitting the cesarean section was performed because of intensifying of premature contractions. Postnatal finding confirmed the diagnosis of duodenal stenosis of the fetus mentioned above. The karyotype was normal.
Afflicted baby underwent laparotomy with normal postoperative course.

Transversal abdominal view with "double bubble" sign.

Postnatal X-ray scans