delineate the level of fusion, connecting vessels and fetal contour (Figure 3). One week later, repeat scans by 3D transvaginal ultrasonography confirmed the diagnosis of conjoined twins. After counseling, the patient opted to terminate the pregnancy. After evacuation, two separate bodies and two separate upper and lower extremities were noted. The location of the conjoined site could not be identified on gross inspection of the abortus because the embryos had been destroyed during the evacuation procedure.Early diagnosis of conjoined twins is crucial for determining subsequent management and possibly decreasing maternal morbidity (evacuation vs. hysterotomy). Specific sonographic findings of conjoined twins examined during the first trimester include inseparable fetal bodies despite manipulation of the uterus with a transvaginal probe or prolonged continuous scanning, bifid appearance of the embryo, single yolk sac 3 , and a single umbilical cord with more than three vessels. Recently, some reports 4 -8 have described early diagnosis of conjoined twins by 3D ultrasound imaging combined with power Doppler, computed tomography and magnetic resonance imaging.In this case, prenatal diagnosis of conjoined twins was established by transvaginal 2D ultrasonography and power Doppler. However, 3D imaging with surfacerendering provided clearer images of the characteristic features of ischiopagus twins and helped the parents to understand the complex anomalies present in their fetuses. Furthermore, it improved our diagnostic confidence to provide adequate early intervention.J.-C. Hsu † and C. T.
Limitations of conservative treatment for repeat Cesarean scar pregnancyA 32-year-old woman, gravida 3, para 3 (Cesarean section 3), was admitted to our hospital due to slight vaginal bleeding at 12 weeks' gestation. Transvaginal ultrasonography revealed a gestational sac and a nonviable embryo at the anterior wall of the uterine isthmus. The myometrium between the gestational sac and urinary bladder was thin. Ectopic pregnancy in
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