A rare case report of vaginal delivery of term conjoined twins with traumatic PPH: patient surviving the ordeal at the cost of the womb

Abstract

Conjoined Twin -"An extremely rare phenomenon "has its incidence from 1 in 49,000 to 1 in 1,89,000 with higher incidence in south east Asia and Africa. Its fetal and maternal outcome depends on the age of gestation, the site of fusion and most of them are still birth babies with the survivors being the female ones. Khavda district of Kacchach (Bhuj, Gujarat, India) witnessed such a delivery of a Cephalothoracophagus conjoined twin in a multigravida who developed traumatic post partum haemorrhage after a normal vaginal delivery and was referred to our hospital which is the only tertiary care centre of Kacchchh district, i.e Bhuj. Case: A 35 year old female patient P7L6D2, presented with severe post partum haemorrhage after vaginal delivery of a full term conjoined twin at community health centre, Khavda. On examination it was a case of traumatic post partum haemorrhage with right colporrhexis with traumatic rupture of uterus. Patient was taken for exploration of tear and colporrhexis and obstetric Hystrectomy was performed. She was saved at the cost of her uterus which bore her a Boon. Where illiteracy prevails; prevails the tradition of multigravid pregnancy with unawareness regarding prenatal screening and antenatal visits which at times costs the patient her life.