Single Fetus FDIU in Triplet Pregnancy

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Figure-1

📄 Report Sample Line - Single Fetus FDIU in Triplet Pregnancy

Ultrasound evaluation reveals a triplet gestation. Of the three fetuses, Fetus B shows absence of cardiac activity, no fetal movement, and reduced amniotic fluid volume. Biometric parameters of Fetus B correspond to approximately XX weeks gestation. No definitive structural anomalies are identified. Fetus A and Fetus C demonstrate normal cardiac activity, movements, and biometry appropriate for gestational age with adequate amniotic fluid volume. Placental morphology suggests a [trichorionic triamniotic / dichorionic triamniotic / monochorionic triamniotic] configuration. No signs of twin-twin transfusion or cord entanglement are noted. Maternal uterus and adnexal structures appear normal.

Conclusion: 📋 Single Intrauterine Fetal Demise (FDIU) of Fetus B in an ongoing triplet pregnancy. Fetus A and Fetus C are viable with sonographically normal findings.

Recommendation: Continued close surveillance of the surviving fetuses with serial growth assessment and Doppler studies. Maternal evaluation for potential causes (e.g., thrombophilia, infection) is recommended. Multidisciplinary management with a maternal-fetal medicine team is advised.

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Note: If you select English, answer all questions in English.
यदि आप हिंदी चुनते हैं, तो सभी प्रश्न हिंदी में हल करें।

1. "Single fetal demise" in a triplet pregnancy means: 1. ट्रिपलेट प्रेगनेंसी में "सिंगल फेटल डिमाइस" का क्या अर्थ है?
A. Death of one fetus in utero while two fetuses remain alive
B. Death of all three fetuses
C. Birth of one fetus only
D. Simultaneous demise of two fetuses

2. The most important factor determining risk to surviving fetuses after single FDIU is: 2. सिंगल FDIU के बाद जीवित भ्रूणों के जोखिम को निर्धारित करने वाला सबसे महत्वपूर्ण कारक कौन सा है?
A. Chorionicity / placental sharing (monochorionic vs dichorionic / trichorionic)
B. Maternal diet
C. Fetal gender of the deceased fetus
D. Time of day when demise was discovered

3. In monochorionic placentation, single fetus demise may directly lead to which complication in surviving co‑fetuses? 3. मोनोकोरियोनिक प्लैसेंटेशन में, एक भ्रूण की मृत्यु जीवित सह‑भ्रूणों में सीधे किस जटिलता का कारण बन सकती है?
A. Guaranteed normal outcome
B. Only maternal fever
C. Acute hemodynamic shift via placental anastomoses causing ischemic brain injury or multi‑organ injury
D. Decreased risk of preterm delivery

4. Immediate evaluation after identifying single FDIU in triplets should include: 4. ट्रिपलेट में सिंगल FDIU की पहचान के बाद तत्काल मूल्यांकन में क्या शामिल होना चाहिए?
A. Confirm chorionicity and perform detailed ultrasound with fetal Dopplers, consider infection screen and counsel parents
B. Immediate cesarean delivery in all cases
C. Start chemotherapy for mother
D. No evaluation required

5. Maternal disseminated intravascular coagulation (DIC) after single fetal demise is: 5. एक भ्रूण मृत्यु के बाद मातृ डायस्मिनेटेड इंट्रावास्कुलर कोआगुलेशन (DIC) क्या है?
A. Very common immediately after any fetal demise
B. Rare but possible, especially with prolonged retention, infection or large dead fetus
C. Impossible
D. Only occurs after delivery

6. Best surveillance plan for surviving fetuses when expectant management is chosen includes: 6. प्रत्याशित (expectant) प्रबंधन चुने जाने पर जीवित भ्रूणों के लिए सर्वश्रेष्ठ निगरानी योजना में क्या शामिल है?
A. Serial ultrasound for growth, umbilical and MCA Dopplers, CTG/NST as indicated; consider fetal MRI if neurological concerns arise
B. Single ultrasound only
C. Immediate planned termination of pregnancy
D. No follow-up required

7. If the mother is stable and surviving fetuses show normal growth and Dopplers, recommended management is: 7. यदि माँ स्थिर है और जीवित भ्रूणों में सामान्य वृद्धि और डॉप्लर है, तो अनुशंसित प्रबंधन क्या है?
A. Immediate delivery regardless of gestation
B. Emergency hysterectomy
C. Expectant management with close surveillance and parental counseling
D. No monitoring needed

8. Prognosis for surviving fetuses is generally better when the pregnancy is: 8. जीवित भ्रूणों का पूर्वानुमान सामान्यतः बेहतर होता है जब गर्भावस्था किस प्रकार की होती है?
A. Monochorionic (shared placenta)
B. Trichorionic or dichorionic (separate placentas)
C. Depends only on maternal age
D. Prognosis is identical in all types

9. Indication for earlier delivery of surviving fetuses would include: 9. जीवित भ्रूणों के जल्दी जन्म के लिए संकेत में क्या शामिल होगा?
A. Evidence of fetal distress, abnormal Dopplers, maternal sepsis or coagulopathy
B. Parental preference only without clinical indication
C. Change in maternal hair color
D. Always deliver immediately at any gestation

10. Key counseling point for parents after single FDIU in triplets is: 10. ट्रिपलेट में सिंगल FDIU के बाद माता‑पिता को दिया जाने वाला प्रमुख परामर्श क्या है?
A. There is no risk to the surviving fetuses and no monitoring needed
B. Explain increased risk of preterm delivery and possible neurological compromise (depending on chorionicity and timing); outline close surveillance plan and neonatal care possibilities
C. Immediate termination is mandatory
D. No obstetric follow-up until term