Early Prenatal Diagnosis of Thoracopagus Twins by Ultrasound

Abstract

Introduction:Conjoined twins are identical twins joined in utero. It’s a rare phenomenon and present a unique challenge to obstetricians and pediatric surgeons. Conjoined twins are complex complication of monozygotic twinning, which is associated with high perinatal mortality.Case report:At our clinic complete anomaly scan was done, the patients was found to have monozygotic twins of 15 weeks gestation and carrying a conjoint twin. Our ultrasound revealed fully developed heads facing each other, joint at the thorax and sharing a common abdomen. These twins share a single heart with two atrium and two ventricle. They decide for termination of pregnancy after taken the opinion of religious people. Termination of pregnancy was performed by many methods and we chose to use cytotec tablets which inserted vaginally and the outcome was conjoint twin with two bodies fused from the upper thorax to lower belly. Both fetuses are female and died immediately after termination of pregnancy.

Dicephalus parapagus conjoined twin: a rare case with review of literature

“…A second theory is more widely accepted. 1 Conjoined twins are of five types that is Thoracopagus, Omphalopagus, Pyopagus, Ischiopagus and Craniopagus. Out of these five, the commonest type is thoracopagus with the reported incidence of 75% and second commonest is thoracopagus which account approximately 18.5%.…”

“…Literature reveals that in one of the study of 14 cases of prenatally diagnosed conjoint twins, 28% died in utero, 54% immediately after birth, and only 18% survived out of which 50% died postoperatively. 1,11 One of the famous conjoined pair named Chang and Eng Bunker lived unseparated for 63 years; they married to two sisters and had 21 children. 5 However survival rate in conjoined twin is still very less.…”

“…The chances of conjoined twin occur if there is division of zygote later than 12 days of fertilization. 1 They are always identical and occur roughly one in every 200 identical twins. Its incidence ranges from 1/50,000 to 1/100,000 live births with somewhat higher incidence is found in Southwest Asia and Africa.…”

Early prenatal diagnosis of conjoined twins: a case report

“…Conjoined twins represent one of the rarest forms of twin gestation, estimated to occur in 1.5 per 100,000 births worldwide. [1][2][3][4] In about 1% of monochorionic pregnancies, the twins are conjoined, probably resulting from relatively late attempts at cleavage on day 13 or later. [1][2][3][4][5] Therefore, when there is a case of monochorionic monoamniotic pregnancy, the possibility of conjoined twins should always be kept in mind.…”

Detection Cephalothoracopagus Case in the First Trimester

“…Bir diğer teoriye göre ise fertilize yumurtanın tam olarak ayrıldığı ama sonrasında kök hüc-relerin kendilerine benzer kök hücrelerini diğer ikizde bularak birleşmeleri sonucunda yapışık ikiz gebelik oluştuğu şeklindedir. 1 Yapışık ikizler monozigot ikiz gebeliklerin 1/100'ünde, gebeliklerin 1/50.000'inde ve yaşayan gebeliklerin 1/250.000'inde gözlenir. 2 Yaklaşık olarak yapışık ikizlerin yarısı canlı doğar.…”