Prenatal Diagnosis of Monocephalic Bifacial Tetraophthalmic Diprosopus (Conjoined Twin)

Abstract

A case of diprosopus twinning which is rare conjoined twinning is reported prenatally at 22 weeks’ gestation. 2D ultrasound examinations showed duplication of the craniofacial structures with four hemispheres, two cerebella and two thalami. There were three orbits two external ears, two noses, fused adjacent maxilla and two oral cavities with two fused oral opening and two jaws. The woman did not consent to any further investigations and the pregnancy was terminated. The postmortem examination confirmed the diagnosis in a male fetus with a crown-rump length of 155 mm, weighing 450 g. The body appeared normal except for a small poorly formed rudiment of a supernumerary digit next to the thumb of the right hand. The ultrasound examination and postmortem finding of this case is described with a short review of the literature.

Diprosopus tetraophthalmus: CT as a complement to autopsy

“…As such, there is no reported increased risk of recurrence. However, some authors suggest a multifactorial pathogenesis caused by interaction between environmental and genetic factors [5].…”

“…The more extensive duplications are associated with more severe central nervous system anomalies. Brain abnormalities include complete or partial duplication of the cerebral hemispheres with varying degrees of fusion of the posterior fossa structures [5,6].…”

“…Imaging of diprosopus includes two-and threedimensional sonography performed pre-natally to show the features of facial duplication [2,5,7]. Polyhydramnios is a frequent finding [3], presumably as a result of impaired swallowing of the amniotic fluid.…”

“…Polyhydramnios is a frequent finding [3], presumably as a result of impaired swallowing of the amniotic fluid. MRI and CT have been used to evaluate the cranial abnormalities following birth and in post-mortem particularly if an autopsy is refused [4,5]. To our knowledge, pre-natal MRI has not yet been described, and description on CT imaging has been limited to the cranium and its contents [3-5, 8, 9].…”

Diprosopus Tetrophthalmus Including Radiological and Post-Partum Images- A Case Report

“…Diprosopus tetrophthalmus is the rarest variant of conjoined twinning which results from incomplete monozygotic, monochorionic and monoamniotic twin division associated with multiple congenital malformations 1,2 . Diprosopus tetrophthalmus is a rarest type of conjoined twins with incidence reported from craniofacial duplication or Diprosopus 180000/15000000 6 .…”