healthy appearing triplet #Placenta. Each arrow points to th | Figure 1

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healthy appearing triplet #Placenta. Each arrow points to the 3 fetal surfaces of the placenta, each displaying its own umbilical cord. The thickened white membranes in the middle are dividing membranes which separate the babies from one another during development. At our hospital, any multiple gestational placenta is sent to Pathology for examination, even if all babies and mom are doing well (which is the case here). In Pathology, we check for placental infarcts, high risk insertion sites for umbilical cords, vascular malformations and imbalances (which can cause things such as Twin-Twin transfusion syndrome), among a slew of other things. This here is a fairly normal triplet placenta so there isn't much else to see here!

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monochorionic-monoamniotic twin placenta. Cords were knotted twice, delivery @ 30 weeks.](https://app.figure1.com/case-detail/33b3f55a-0218-4fc8-99d8-0fd73f68348c)

twin #Placenta showing a velamentous cord insertion, where the #Umbilical-cord inserts into the membranes before it reaches the placental disc. In this case, the cord inserts into the dividing membrane (other placental disc is on other side of membranes). This can (but doesn't always) create a serious problem for the baby or babies. Since these vessels are usually protected by the placenta itself, having them exposed like this with a weak support, they are much more susceptible to rupture. The obstetric complication is known as #Vasa-previa and can also occur with accessory-lobed placentas.](https://app.figure1.com/case-detail/3b3fbb1c-c8e5-42ad-b21a-ddedaf990e01)

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Triplet fetal demise. Arrow at twin placenta. Weeks were not indicated.](https://app.figure1.com/case-detail/53716021-1e41-4aa3-9991-f2e072fffa0f)

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