Abstract
Background: Multifetal gestation is problematic for both the mother and her fetuses, as it dramatically increases the rate of perinatal morbidity and mortality. In addition, the risks for congenital anomalies and their consequences are higher with multifetal gestations. Case Presentation: A 26-year-old mother, married for 3 years, with a known case of polycystic ovarian syndrome, had a normal vaginal delivery 18 months ago. The patient visited the infertility clinic on June 20 2021, where ovulation induction was started and three dominant follicles were seen. When ultrasonography was done at GA of 11 weeks, it showed triplet pregnancy. The patient was counseled regarding her triplet pregnancy and was referred for fetal reduction, but the patient refused. The patient was admitted to at GA 34 weeks, and an emergency Cesarean section was done. All neonates were females, the first one (one with a normal head had a low Apgar score) was managed in the neonatal intensive care unit. While the other two were anencephalic and died immediately. Conclusion: The underlying etiology for anencephaly is multifactorial, involving genetic predisposition with exposure to environmental factors, thus folic acid could be used to prevent neural tube defect. Further, anencephaly could be diagnosed by transvaginal sonography as early as 11-14 weeks.
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