Prenatal Diagnosis of Cephalophagus Conjoined Twins by Ultrasonography and Magnetic Resonance Imaging

Kapoor, Ravi; Bansal, Ashutosh; Aggarwal, Abhinav; Aggarwal, Aakriti Kapoor; Taneja, Radhika Batra

doi:10.1007/s40556-015-0039-x

Cited by 4 publications

(3 citation statements)

References 12 publications

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“…There are two types of cephalopagus twins: Janiceps (two faces are on the either side of the head) and non-janiceps (with one head and a single face). Non-janiceps type of cephalopagus are extremely rare variety of conjoined twins [4]. These twins usually die in utero or immediately after birth.…”

Section: Discussionmentioning

confidence: 99%

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A case report on prenatal diagnosis of Non Janiceps type of cephalopagus conjoined twins

Srin

Rajgarhia

Regmi

et al. 2022

Preprint

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Background Conjoined twin pregnancy is a rare occurrence resulting from the failure of a zygote to separate completely after 13 days. Cephalopagus type is the rarest type of conjoined twins. There are two types of cephalopagus twins: Janiceps (two faces are on the either side of the head) and non-janiceps (with one head and a single face). Non-janiceps type of cephalopagus are extremely rare variety of conjoined twins. Case presentation: A 19Y old female, primigravida, presented at 12 weeks of gestation for antenatal ultrasound. USG showed evidence of a conjoined twin with a single head with single face, fused thoraces with single heart, two lungs, fused upper abdomen with shared stomach and liver, separate pelvises with two different bladders and two pairs of upper and lower limbs. Fetal MRI corroborated these findings. The pregnancy was terminated and cephalopagus fetus was delivered vaginally. The parents were appropriately counselled for future pregnancies. Conclusion An extremely rare case of non-Janiceps type of cephalopagus conjoined twin gestation which was detected at 12 weeks of geatation by antenatal ultrasound and confirmed on fetal MRI. Early antenatal diagnosis is extremely important for appropriate and timely management as the prognosis is very poor in such twins. Antenatal ultrasound and fetal MRI prove very beneficial in this aspect as well as fordiagnosis of other associated fetal abnormalities.

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Section: Discussionmentioning

confidence: 99%

“…Cephalopagus twinning is the rarest type of conjoined twinning accounting for about 1 per million births [4] and has a very poor prognosis. Because of extensively shared organs, surgical separation of such twins after delivery have been rarely successful.…”

Section: Introductionmentioning

confidence: 99%

A case report on prenatal diagnosis of Non Janiceps type of cephalopagus conjoined twins

Srin

Rajgarhia

Regmi

et al. 2022

Preprint

View full text Add to dashboard Cite

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“…The tools that can be used for early detection are ultrasonography and MRI. 4 Conjoined twins can be challenging to diagnose accurately, especially in the early stages of pregnancy. Sometimes, a diagnosis might be ambiguous, necessitating additional imaging or specialist testing.…”

Section: Introductionmentioning

confidence: 99%

Early diagnosis and management of inseparable conjoint twins. A low-middle-income country experience

Aditiawarman

2024

MOG

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HIGHLIGHTS Conjoined twins have captivated mankind for centuries due to the rarity of this birth type; nonetheless, physicians have constantly encountered difficulties in dealing with conjoined twins. Early diagnosis of conjoined twins during prenatal examination is critical for ascertaining the prognosis of the fetus, guiding parental counseling over appropriate courses of action, and potentially enabling the termination of the pregnancy. First-trimester ultrasonography and MRI are complementary modalities in determining the diagnosis and prognosis of conjoined twins in early pregnancy. ABSTRACT Objectives: To discuss the crucial early diagnosis of conjoined twins to determine the type and prognosis. Case Report: A 27-year-old woman was referred to the type A referral hospital with suspicion of congenital abnormalities at 17 weeks of pregnancy. Ultrasound results showed intrauterine monochorionic monoamniotic twins with babies fused on their heads to the urogenital part. The MRI showed a craniopagus, suspected meningomyelocele, and severe bilateral hydronephrosis in the second baby. Due to non-separable cases and a bad prognosis for the fetus, the pregnancy was terminated using misoprostol induction and inserting a balloon catheter. The fetus is born weighing 400 g and 20 cm in length. Conjoined twins obtained the rostral type: a fused head with two faces, a fused thorax until the lower abdomen with one umbilicus, and two pairs of hands and feet. The diagnosis of conjoint twins becomes a problem in early pregnancy, mostly in developing countries. Early diagnosis of conjoined twins during prenatal examination is critical for ascertaining the prognosis of the fetus, guiding parental counseling over appropriate courses of action, and potentially enabling the termination of the pregnancy to prevent maternal stress and complications. Conclusion: Conjoined twins should be identified as soon as feasible to establish the best course of management for both mother and fetus. Ultrasonography and MRI are modalities for determining the diagnosis and prognosis of conjoined twins.

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Prenatal diagnosis of non-janiceps type of cephalopagus conjoined twins: a case report

Srinath

Rajgarhia

Regmi

et al. 2023

Egypt J Radiol Nucl Med

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Background Conjoined twin pregnancy is a very rare variety of twin pregnancy which results from the failure of complete separation of a zygote after 13 days, ‘cephalopagus’ being the rarest variety of such twin pregnancies. Two forms of cephalopagus conjoined twins have been described in the literature: Janiceps (two faces are on the either side of the head) and non-janiceps (with one head and a single face); non-janiceps type being even rarer. The features that may hint towards the diagnosis on ultrasound include inseparable fetal bodies, unvarying relative positioning of the two fetuses, both heads persistently at the same level to each other, bi-breech or bicephalic presentations and a single umbilical cord with more than three vessels. 3-D ultrasound and Fetal MRI may help in confirmation of this rare entity. Case presentation A 19-year-old primigravida, presented at 12 weeks of gestation for antenatal ultrasound. Ultrasonography showed evidence of a conjoined twin with a single head and single face, fused thoracic cavities with single heart, two lungs, fused upper abdomen with shared stomach and liver, separate pelvic cavities with two different urinary bladders and two pairs of upper and lower limbs. Fetal MRI corroborated these findings. The pregnancy was terminated vaginally, and cephalopagus fetus was delivered. The parents were appropriately counselled for future pregnancies. Conclusions A very rare case of non-Janiceps variety of cephalopagus conjoined twin gestation which was detected at 12 weeks of gestation by antenatal ultrasound and confirmed on fetal MRI. Early antenatal diagnosis is extremely important for appropriate and timely management as the prognosis is very poor in such twins. Antenatal ultrasound and fetal MRI prove very beneficial in this aspect as well as for diagnosis of other associated fetal abnormalities.

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Prenatal Diagnosis of Cephalophagus Conjoined Twins by Ultrasonography and Magnetic Resonance Imaging

Abstract: Cephalopagus is the rarest type of conjoined twins. Early antenatal diagnosis is important in view of extremely poor prognosis as surgical separation is not possible in such cases. Fetal MRI is an excellent complementary tool to prenatal sonography in assessment of complex fetal anomalies.

Cited by 4 publications

References 12 publications

A case report on prenatal diagnosis of Non Janiceps type of cephalopagus conjoined twins

A case report on prenatal diagnosis of Non Janiceps type of cephalopagus conjoined twins

Early diagnosis and management of inseparable conjoint twins. A low-middle-income country experience

Prenatal diagnosis of non-janiceps type of cephalopagus conjoined twins: a case report

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