IntroductionConjoined twins are identical twins with fused bodies, joined in utero. They are rare complications of monochorionic twinning. The purpose of this study is to describe the various types of conjoined twins, the role of imaging and recent advances aiding in their management.Material and methodsThis was a twin institutional study involving 3 cases of conjoined twins diagnosed over a period of 6 years from 2010 to 2015. All the 3 cases were identified antenatally by ultrasound. Only one case was further evaluated by MRI.ResultsThree cases of conjoined twins (cephalopagus, thoracopagus and omphalopagus) were accurately diagnosed on antenatal ultrasound. After detailed counseling of the parents and obtaining written consent, all the three cases of pregnancy were terminated. Delivery of the viable conjoined twins was achieved without any complications to the mothers, and all the three conjoined twins died after a few minutes.ConclusionUltrasound enables an early and accurate diagnosis of conjoined twins, which is vital for obstetric management. MRI is reserved for better tissue characterization. Termination of pregnancy when opted, should be done at an early stage as later stages are fraught with problems. Recent advances, such as 3D printing, may aid in surgical pre-planning, thereby enabling successful surgical separation of conjoined twins.

Background: Antenatal care services including supplementary nutrition services are the essential services for reducing maternal mortality. As per National Family Health Survey (NFHS) 4 data, 62% pregnant mothers received supplementary nutrition in Karnataka state and only 49.4% received health and nutrition education. Study was conducted to assess utilization of antenatal services with special reference to supplementary nutrition and advice on nutrition.Methods: A cross sectional study was conducted among the mothers admitted in obstetrics and gynecology department of Yenepoya Medical College Hospital. All the 140 mothers admitted during August and September 2017 for safe confinement of pregnancy were enrolled in this study and data was collected using semi-structured questionnaire. SPSS software version 22 was used for data analysis. Descriptive statistics was expressed in terms of frequencies and percentages. Chi square test was used to study the factors association with utilization of antenatal services.Results: Of the 140 participants, most of them i.e. 38.6% were in 25-30 years age group. The mean age was 46 years. Only 86 mothers (61.42%) received supplementary nutrition of whom only 53 (37.85%) had consumed it. Utilization of antenatal services was 100% with respect to minimum antenatal visits, routine laboratory investigations and TT immunization. Awareness about Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) was very poor (5%). Educational status of mother was found to be associated with utilization of supplementary nutrition (p=0.026).Conclusions: Utilization of routine antenatal services was reported to be very good. Efforts should be made to improve utilization about supplementary nutrition and awareness about nutrition education.