**6. Exceptional situations**

Although the data about triplet pregnancies are still limited, and the monoamniotic and diamniotic triplets should be delivered between 32 + 0 and 32 + 6 weeks [38], most studies and guidelines suggest delivery time at no later than 36 weeks, even in uncomplicated triamniotic triplets [6, 39, 40]. The preferred delivery route is the cesarean section because vaginal delivery is associated with an increased risk of adverse outcomes if compared with the cesarean [41, 42].

In conjoined twins, the data available is based in small case report studies and expert opinion, but what is suggested is the delivery time and mode of the viable ones must be near term cesarean section after confirming lung maturity. In selected cases an EXIT procedure can be performed in order to stabilize the fetuses with cardiac union to examine and close the vessel communication safely [43].
