Thoraco-omphalopagus conjoined twin: A rare case report

Poudel, Diptee; Shrestha, Suraj; Aryal, Roshan; Adhikari, Ashmita; Bajracharya, Sunita

doi:10.1016/j.ijscr.2022.107683

Cited by 3 publications

(3 citation statements)

References 20 publications

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“…Fortunately, in this study, the procedure and postoperative period proceeded without significant complications, and the patient consented for female sterilization. 1,3,5,8,9 The postnatal course of non-operative management is chosen when complex cardiac anomalies preclude separation and heart reconstruction. Thoracopagus twins may exhibit varied cardiac anomalies, which are grouped into four categories: Group A (separate hearts and separate pericardium), Group B (separate hearts but a common pericardium), Group C (fuzed atria and separate ventricles), and Group D (atrial and ventricular fusion).…”

Section: Discussionmentioning

confidence: 99%

A Case Report of Thoraco-Omphalopagus Conjoined Twins: The Downfall of the Separated Hearts

Safira,

Chalid,

Madya

2024

Obgynia

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Introduction: Thoraco-omphalopagus conjoined twins are a rare occurrence of monozygotic pregnancy that involves fusion of the anterior thorax and abdomen. This type presents a variety of cardiac anomalies, which contribute to its generally unfavorable prognosis.Case Presentation: A 32-year-old multigravida with Gravida 6, Para 4, and Abortus 1 was referred at 28 weeks of gestation. Ultrasonography revealed thoracoomphalopagus-conjoined twins in which the fetuses joined ventrally. Prenatal MRI revealed the sharing of a single liver, omentum, and diaphragm. Partial fusion was observed in the sternal bone, pericardium, and anterior wall of the hearts, but with separated heart chambers and unsynchronized heartbeats. Classical cesarean section was performed at 38 weeks of gestational age. Histopathology revealed a single placenta with one umbilical cord, suggesting monochorionic– monoamniotic pregnancy. Healthy female babies were born with a combined weight of 5400 g. Post-delivery echocardiography revealed a cardiac anomaly characterized by malposition of the great arteries in a twin. After 13 h of close monitoring in the NICU, the twins died due to cardiac complications.Conclusion: The management of pregnancy involving thoraco-omphalopagus conjoined twins requires a comprehensive and multi-disciplinary approach aiming to provide holistic care, addressing complex medical risks, and ethical dilemmas associatedwith these twins.Laporan Kasus Mengenai Kembar Siam Torako-Omfalopagus: Prognosis Buruk pada Jantung yang TerpisahAbstrakPendahuluan: Kembar siam thoraco-omphalopagus adalah kejadian langka pada kehamilan monozigot yang melibatkan penyatuan antara toraks dan abdomen anterior. Tipe ini diketahui dapat disertai adanya kelainan jantung yang berkontribusi terhadap prognosis yang umumnya kurang baik.Presentasi Kasus: Multigravida berusia 32 tahun dengan Gravida 6, Para 4, Abortus 1, dirujuk pada usia kehamilan 28 minggu. Ultrasonografi menunjukkan kembar siam torako-omfalopagus di mana janin menyatu secara ventral. MRI prenatal memperlihatkan adanya fusi organ hati, omentum dan diafragma. Di sisi lain, fusi parsial diamati pada sternum, perikardium, dan dinding anterior jantung, dengan ruang jantung terpisah dan detak jantung yang tidak bersifat sinkron.Seksio sesarea klasik dilakukan pada usia kehamilan 38 minggu. Histopatologi menunjukkan plasenta tunggal dengan satu tali pusat sugestif kehamilan monokorionik-monoamniotik. Dua bayi perempuan sehat lahir dengan berat kombinasi 5.400 gram. Ekokardiografi pascasalin menunjukkan adanya anomali jantung berupa malposisi arteri besar pada salah satu bayi. Setelah 13 jam observasi ketat di NICU, kedua bayi kembar meninggal akibat komplikasi jantung.Kesimpulan: Penatalaksanaan kehamilan kembar siam thoraco-omphalopagus memerlukan pendekatan komprehensif dan multidisiplin yang bertujuan untuk memberikan perawatan holistik, mengatasi risiko medis, dan dilema etika yang terkait.Kata kunci: Kembar Siam; Kembar Monozigotik; Thoraco-omphalopagus

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Section: Discussionmentioning

confidence: 99%

A Case Report of Thoraco-Omphalopagus Conjoined Twins: The Downfall of the Separated Hearts

Safira,

Chalid,

Madya

2024

Obgynia

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“…Thoraco-omphalopagus is a step condition in which a severely deformed fetus is attached to the thorax and upper abdomen of the main fetus (autosite). 26 10. Prosopo-thoracopagus.…”

Section: Types Of Conjoined Twinsmentioning

confidence: 99%

Conjoined Twin Marriages in the Perspective of Islamic Law

Ma’adul Yaqien Makkarateng,

Muljan,

Nurfajriani

2023

JHI

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Conjoined twins have rights that must be fulfilled like other humans, namely the right to marry. However, Islamic Law scholars still debate the validity of conjoined twin marriages. This research discusses the debate about the marriage of conjoined twins in Islamic law. The research method uses normative juridical with an Islamic legal approach. The results show that conjoined twins are generally divided into two groups, conjoined twins who can be separated by surgery and conjoined twins who cannot be separated by surgery. Based on the organs or body parts that are connected or united, conjoined twins are divided into several types, such as cephalopagus, thoracopagus, omphalopagus, ischiopagus, craniopagus, heteropagus, epigastric heteropagus, phygopagus, thoraco-omphalopagus, prosopo-thoracopagus, rachipagus, parapagus and dicephalic parapagus. Islamic law does not specifically explain the type of marriage of conjoined twins. However, the law of conjoined twin marriage can be determined by classifying whether each conjoined twin has the consciousness of one person or two people. Besides that, it can also be determined by organising it into one person from below the navel and two people united to form two bodies above. The legal determination of twins on different bases means that the validity of conjoined twin marriages is still debated in Islamic law.

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“…However, the latest data showed that conjoined twins occur in one per 250,000 births (Zainuddin et al, 2021). The separation of conjoined twins presents a unique challenge due to its rarity (Poudel et al, 2022). Although omphalopagus twins have the best survival chances, adequate pre-operative planning is required (Van Klei et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

A successful separation of omphalopagus twins during COVID-19 pandemic: A case report

et al. 2023

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Background: Omphalopagus is a rare condition involving digestive system and abdominal wall fusion. This study reports an omphalopagus case during the early phase of the coronavirus disease 2019 (COVID-19) pandemic in Indonesia.Case: Male conjoined twins, aged 14 months, were diagnosed with omphalopagus and several organ failures. We performed separation surgery of the omphalopagus with primary closure and post-surgical care for fifteen days. The early surgery was preferable in this case due to life-threatening issues of COVID-19, despite omphalopagus separation may cause post-surgical complications. Furthermore, the emerging pandemic conditions also required a more stringent procedure to avoid the risk of viral spread.Conclusion: We conclude that, in the lack of evidence-based instruction for hospital care during the early phase of COVID-19 in Indonesia, life-saving surgical considerations from death due to complications of COVID-19 infection and acute respiratory distress syndrome must be performed and prioritized. However, potential omphalopagus complications must be evaluated.

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Thoraco-omphalopagus conjoined twin: A rare case report

Cited by 3 publications

References 20 publications

A Case Report of Thoraco-Omphalopagus Conjoined Twins: The Downfall of the Separated Hearts

A Case Report of Thoraco-Omphalopagus Conjoined Twins: The Downfall of the Separated Hearts

Conjoined Twin Marriages in the Perspective of Islamic Law

A successful separation of omphalopagus twins during COVID-19 pandemic: A case report

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