Conjoined twins in a monozygotic triplet pregnancy: Prenatal diagnosis and X‐inactivation

Zeng, She Min; Yankowitz, Jerome; Murray, Jeffrey C.

doi:10.1002/tera.10091

Cited by 15 publications

(8 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This selection for fetal survival by sex seems to be more likely than the hypothesis suggesting that abnormal X-inactivation contributes to the formation of MZ and conjoined twins, thereby leading to a higher incidence of conjoining in female embryos [28]. This hypothesis was not confirmed in a recent study where DNA polymorphism analysis with 13 markers was used [29]. However, the possibility of survival will strongly depend not only on the type of fusion and the organs involved but also on the concomitant malformations.…”

Section: Clinical Aspectsmentioning

confidence: 64%

Epidemiological and clinical analysis of a consecutive series of conjoined twins in Spain

Martı́nez-Frı́as

Bermejo

Peña

et al. 2009

Journal of Pediatric Surgery

View full text Add to dashboard Cite

Section: Clinical Aspectsmentioning

confidence: 64%

Epidemiological and clinical analysis of a consecutive series of conjoined twins in Spain

Martı́nez-Frı́as

Bermejo

Peña

et al. 2009

Journal of Pediatric Surgery

View full text Add to dashboard Cite

“…The first of the present cases involved one normal fetus as well as inseparable conjoined twins, a situation that is extremely rare. 3,4 In this case, the pregnancy had to be continued in order to save the normal fetus. In the second case, the parents strongly desired to continue the pregnancy for religious reasons.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of conjoined twinning is one in every 10 000 to 50 000 deliveries, or 0.5% of all pregnancies involving monochorionic twins 1,2 . The occurrence of conjoined twins in a triplet pregnancy is extremely rare 3,4 . Therefore reports on pregnancy management in cases of conjoined twins are exceptionally rare, as most mothers opt to terminate pregnancy at the time of diagnosis, 5 even in cases of triplet pregnancy 3 .…”

Section: Introductionmentioning

confidence: 99%

“…1,2 The occurrence of conjoined twins in a triplet pregnancy is extremely rare. 3,4 Therefore reports on pregnancy management in cases of conjoined twins are exceptionally rare, as most mothers opt to terminate pregnancy at the time of diagnosis, 5 even in cases of triplet pregnancy. 3 Here we report two consecutively experienced cases of conjoined twin pregnancy in which the mothers opted for live birth, with details of the protocol we established for management.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Two cases of pregnancy involving conjoined twins, with details of management after opting for live birth

Takae

Izuchi

Murayama

et al. 2011

J of Obstet and Gynaecol

View full text Add to dashboard Cite

Conjoined twinning is a unique complication of monochorionic pregnancy. This report describes the clinical findings in two cases of conjoined twins, and discusses their management. One case involved thoracopagus complicating a triplet pregnancy, and the other involved cephalothoracopagus, in which the outcome was intrauterine fetal death due to abruptio placentae after amniocentesis. Recent improvements in ultrasound imaging have facilitated the diagnosis of conjoined twins as early as the first trimester. Although many mothers opt to terminate pregnancy when conjoined twins are diagnosed, a few do not, as in the cases described. In such cases, pregnancy management, including accurate determination of the degree of organ fusion and psychological follow up, are important. On the basis of the two present cases, we present a systematic flow diagram for management of conjoined twin pregnancy from the time of diagnosis until delivery.

show abstract

“…Molecular analyses however, failed to show any association between chromosome X inactivation and conjoined fetuses. 27 On the other hand, epigenetic or even genetic changes should be present at least at the interface of fetal conjunction, and this possibility could be answered by future studies.…”

Section: Etiopathogenesismentioning

confidence: 99%

Prenatal Diagnosis and Management of Conjoined Fetuses

Mikos¹,

Athanasiadis²,

Zafrakas³

2007

Donald School Journal of Ultrasound in Obstetrics and Gynecology

View full text Add to dashboard Cite

Conjoined twins have an estimated incidence of one in 50,000 to one in 100,000 births. The first cases of prenatal diagnosis of conjoined twins using B-mode ultrasound were reported in the 1970s, followed by prenatal real-time ultrasonographic diagnosis shortly thereafter. Since then, real-time ultrasound has been the most reliable method in establishing prenatal diagnosis of conjoined twins and in detecting associated anomalies. Moreover, recent improvements in real-time ultrasound technology -in some cases coupled with use of Magnetic Resonance Imaging (MRI) -have made early diagnosis of conjoined fetuses in the first trimester possible. Prenatal diagnosis of conjoined fetuses is considered essential for further management. Parents need detailed counseling in order to decide among various management options, which include the following: (a) pregnancy continuation and scheduled neonatal surgery, (b) termination of pregnancy, and (c) multifetal pregnancy reduction or selective fetocide in cases of high-order multifetal pregnancies with a component of conjoined fetuses. An interdisciplinary medical team, involving obstetricians, neonatologists, pediatric surgeons and anesthetists, should carefully approach and assist parents in their decisions. In special cases, additional consultation may be given by other specialists, even from specialized centers in other countries, depending on the area of conjunction, the involvement of other organ systems, and the presence of associated anomalies.

show abstract

Conjoined twins in a monozygotic triplet pregnancy: Prenatal diagnosis and X‐inactivation

Abstract: Genetic or environmental factors other than abnormal X-inactivation must be involved in causing monozygous multiple gestation or CTS. Despite prenatal diagnosis, shared myocardium or cardiac anomalies in CTS often determine the prognosis.

Cited by 15 publications

References 16 publications

Epidemiological and clinical analysis of a consecutive series of conjoined twins in Spain

Epidemiological and clinical analysis of a consecutive series of conjoined twins in Spain

Two cases of pregnancy involving conjoined twins, with details of management after opting for live birth

Prenatal Diagnosis and Management of Conjoined Fetuses

Contact Info

Product

Resources

About