The results disclosed that complementary exams, such as MRI and echocardiography, are important to better define the observed defects. Some of them, such as congenital heart defects, may be more common than previously reported. This definition is essential for the proper management of the pregnancy and genetic counseling of the family. The birth of these children must be planned with caution and for the prognosis a long survival possibility, despite unlikely and rare, must be considered.
OBJECTIVE To review the history, epidemiology, etiology, gestational aspects,
diagnosis and prognosis of imperfect twinning. DATA SOURCES Scientific articles were searched in PubMed, SciELO and Lilacs databases,
using the descriptors "conjoined twins", "multiple
pregnancy", "ultrasound", "magnetic
resonance imaging" and "prognosis". The
research was not delimited to a specific period of time and was supplemented
with bibliographic data from books. DATA SYNTHESIS: The description of conjoined twins is legendary. The estimated frequency is
1/45,000-200,000 births. These twins are monozygotic, monochorionic and
usually monoamniotic. They can be classified by the most prominent fusion
site, by the symmetry between the conjoined twins or by the sharing
structure. The diagnosis can be performed in the prenatal period or after
birth by different techniques, such as ultrasound, magnetic resonance
imaging and echocardiography. These tests are of paramount importance for
understanding the anatomy of both fetuses/children, as well as for prognosis
and surgical plan determination. CONCLUSIONS Although imperfect twinning is a rare condition, the prenatal diagnosis is
very important in order to evaluate the fusion site and its complexity.
Hence, the evaluation of these children should be multidisciplinary,
involving mainly obstetricians, pediatricians and pediatric surgeons.
However, some decisions may constitute real ethical dilemmas, in which
different points should be discussed and analyzed with the health team and
the family.
CONTEXT AND OBJECTIVE: Trisomy 18 (T18), or Edwards syndrome, is a chromosomal disease characterized by a broad clinical picture and a poor prognosis. Our aim was to describe clinical, radiological and survival data of a cohort of patients prenatally diagnosed with T18.
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