Prenatal Diagnosis of an Extremely Rare Type of Conjoined Twins: Cranio-Rachi-Pygopagus Twins

Durin, Luc; Hors, Y.; Jeanne-Pasquier, Corinne; Barjot, Philippe; Herlicoviez, M.; Dreyfus, Michel

doi:10.1159/000082442

Cited by 10 publications

(7 citation statements)

References 24 publications

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“…With the advent of ultrasound technology, detection of conjoined twinning can be done very early in pregnancy, even for rare forms [20,21] . However, scanning for nuchal translucency measurement between 11 and 14 weeks of gestation allows clinicians a more accurate diagnosis of conjoined twinning and also gives a chance for major anomaly detection in embryos.…”

Section: Discussionmentioning

confidence: 99%

Conjoined Twins in a Trichorionic Quadruplet Pregnancy after Ovulation Induction with Clomiphene Citrate

Mendilcioğlu

Şi̇mşek²

2008

Fetal Diagn Ther

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Objective: We report a case of conjoined twins in a trichorionic quadruplet pregnancy after ovulation induction with clomiphene citrate for anovulation. Methods: The diagnosis of a trichorionic quadruplet pregnancy was made in routine ultrasound at 11 weeks’ gestation. Results: Conjoined twinning was thoracopagus and presented with increased nuchal translucency. Selective termination of the conjoined twins was performed with potassium chloride injection. The patient delivered 2 healthy infants after an uneventful follow-up. Conclusion: Monozygotic twinning has increased with widespread usage of ovulation induction agents and assisted reproductive techniques. Early detection of conjoined twinning and chorionicity is essential for an optimal obstetric management and outcome.

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Section: Discussionmentioning

confidence: 99%

Conjoined Twins in a Trichorionic Quadruplet Pregnancy after Ovulation Induction with Clomiphene Citrate

Mendilcioğlu

Şi̇mşek²

2008

Fetal Diagn Ther

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“…C). Only two reports of nonparasitic rachipagi exist, described by Bétoulières et al () and Durin et al (). Both cases concern rachipagi with cranial conjunction (cranio‐rachipagus).…”

Section: Types Of Conjoined Twinsmentioning

confidence: 99%

Two is a Crowd

2019

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In this article, we provide a comprehensive overview of multiple facets in the puzzling genesis of symmetrical conjoined twins. The etiopathogenesis of conjoined twins remains matter for ongoing debate and is currently cited—in virtually every paper on conjoined twins—as partial fission or secondary fusion. Both theories could potentially be extrapolated from embryological adjustments exclusively seen in conjoined twins. Adoption of these, seemingly factual, theoretical proposals has (unconsciously) resulted in crystallized patterns of verbal and graphic representations concerning the enigmatic genesis of conjoined twins. Critical evaluation on their plausibility and solidity remains however largely absent. As it appears, both the fission and fusion theories cannot be applied to the full range of conjunction possibilities and thus remain matter for persistent inconclusiveness. We propose that initial duplication of axially located morphogenetic potent primordia could be the initiating factor in the genesis of ventrally, laterally, and caudally conjoined twins. The mutual position of two primordia results in neo‐axial orientation and/or interaction aplasia. Both these embryological adjustments result in conjunction patterns that may seemingly appear as being caused by fission or fusion. However, as we will substantiate, neither fission nor fusion are the cause of most conjoined twinning types; rather what is interpreted as fission or fusion is actually the result of the twinning process itself. Furthermore, we will discuss the currently held views on the origin of conjoined twins and its commonly assumed etiological correlation with monozygotic twinning. Finally, considerations are presented which indicate that the dorsal conjunction group is etiologically and pathogenetically different from other symmetric conjoined twins. This leads us to propose that dorsally united twins could actually be caused by secondary fusion of two initially separate monozygotic twins. An additional reason for the ongoing etiopathogenetic debate on the genesis of conjoined twins is because different types of conjoined twins are classically placed in one overarching receptacle, which has hindered the quest for answers. Clin. Anat. 32:722–741, 2019. © 2019 Wiley Periodicals, Inc.

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“…No passado o diagnóstico pré-natal de gêmeos coligados não era possível, sendo hoje realizado na maioria dos casos com o uso da ultra-sonografia 10,[12][13][14][15][16][17][18] . Alguns critérios ultra-sonográficos para diagnóstico foram estabelecidos, como: ausência de membrana divisória, impossibilidade de identificação completa dos corpos fetais durante a exploração ultra-sonográ-fica, detecção de anomalias fetais e presença de mais de três vasos no cordão umbilical 19 .…”

Section: Introductionunclassified

Diagnóstico pré-natal de gêmeos unidos com uso da ressonância nuclear magnética: relato de dois casos

Souza¹,

Medeiros²,

Neto³

et al. 2006

Rev. Bras. Ginecol. Obstet.

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Prenatal Diagnosis of an Extremely Rare Type of Conjoined Twins: Cranio-Rachi-Pygopagus Twins

Abstract: Prenatal diagnosis of conjoined twins is rare. An accurate diagnosis is important to provide the parents the best information about the prognosis of the twins. We report a first-trimester diagnosis of an extremely rare type of conjoined twins using two-dimensional transvaginal ultrasound.

Cited by 10 publications

References 24 publications

Conjoined Twins in a Trichorionic Quadruplet Pregnancy after Ovulation Induction with Clomiphene Citrate

Conjoined Twins in a Trichorionic Quadruplet Pregnancy after Ovulation Induction with Clomiphene Citrate

Two is a Crowd

Diagnóstico pré-natal de gêmeos unidos com uso da ressonância nuclear magnética: relato de dois casos

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