Vaginal birth of conjoined thoracopagus – a rare event

Abstract

An extremely rare case of vaginal birth of preterm conjoined thoracopagus twins diagnosed after delivery is being described and brief review of literature discussed.

Anaesthetic management of a craniopagus conjoined twin delivery

“…1,2 Craniopagus conjoined twins (CCT) are even more rare, accounting for only 5% of all conjoined twin pregnancies. 2 CCT result from an asymmetrical dorsolateral union of any part of the skull excluding the face and foramen magnum, allowing for the sharing of the bony cranium and meninges and sometimes the brain.…”

Vaginal Delivery of Dicephalic Parapagus Conjoined Twins: Case Report and Literature Review

“…Where access to technology is limited, as in our case, antepartum diagnosis of CTs may be nearly impossible (Apuzzio et al 1984;Grover et al 1990;Agarwal et al 2003). Prenatal identification of conjoined twins was rare before ultrasonography was available (Fitzgerald et al 1985;Barth et al 1990).…”

“…There are many reported vaginal deliveries of CTs (Pennings et al 1982;Hoogeboom et al 1983;Sakala 1986;Itoh et al 1993;Shija et al 1994;Creinin 1995;Agarwal et al 2003). Although compressible fetal tissues may facilitate vaginal birth (Agarwal et al 2003), dystocia, uterine rupture, or maternal soft tissue injury can occur (Sakala 1986;Creinin 1995).…”

“…Prenatal identification of conjoined twins was rare before ultrasonography was available (Fitzgerald et al 1985;Barth et al 1990). Sometimes twins are unsuspected at delivery of CTs (Grover et al 1990;Groner et al 1996;Agarwal et al 2003), while auscultation, palpation, and even ultrasound suggest separate twins at other times (Klug et al 1978;Fitzgerald et al 1985;Sakala 1986). …”

“…Although compressible fetal tissues may facilitate vaginal birth (Agarwal et al 2003), dystocia, uterine rupture, or maternal soft tissue injury can occur (Sakala 1986;Creinin 1995). When CTs are identified before birth, Cesarean section is preferred, to avoid maternal trauma and to facilitate treatment of viable neonates (Fitzgerald et al 1985;Creinin 1995;Bianchi et al 2000).…”