Twin-To-Twin Transfusion Syndrome in Dichorionic-Triamniotic Triplets Successfully Managed Without Fetoscopic Laser: A Management-Focused Case Report.

Triplet pregnancies are rare (~0.1% of births) and often complicated by prematurity. When one placental unit is monochorionic, there is a risk of twin-to-twin transfusion syndrome (TTTS), a severe vascular imbalance affecting monochorionic gestations. We report a 29-year-old primigravida with a dichorionic-triamniotic triplet pregnancy complicated by Quintero stage II TTTS affecting the monochorionic twin pair. The patient was managed with close surveillance, serial amnioreductions, and antenatal corticosteroids. At 32 + 6 weeks' gestation, three male infants were delivered by cesarean section with favorable neonatal outcomes following neonatal intensive care. This case demonstrates that, in selected late-gestation triplet pregnancies complicated by TTTS, conservative management with amnioreduction and planned preterm delivery may be a reasonable alternative when fetoscopic laser therapy is not feasible.