Dicephalic parapagus twin - A rare case report

Abstract

We are reporting a rare case of a dicephalic parapagus twin born to multigravida mother diagnosed antenatally few hours before birth by ultrasonography. The baby was born by emergency cesarean section. The baby was full-term live male baby; however, the baby expired few hours after birth. Due to the rarity of the case, we are prompted to report this case.

Case Report : Dicephalic parapagus conjoined twins

“…Fetal head in the same plane, no change in relative position following maternal movement, lack of a dividing membrane, more than three vessels in the cord central, and failure to separate the fetal body are all symptoms that can support the diagnosis (parai at al., 2016). Ideally, a diagnosis should be made in the first trimester so that the delivery can be scheduled to minimize maternal morbidity (Singh et al 2017). In this report, the conjoined twin was discovered for the first time at 29 weeks and 20 weeks of gestation, respectively, making vaginal delivery impossible due to the combined size of the fetal head diameter.…”

“…Two competing ideas about embryology have been put forth to explain the clinical polymorphism of this abnormality. According to the fission theory, it is the second fusing of two previously split embryonic discs after the embryonic disc's final incomplete separation (fusion theory) (Singh et al, 2017). The area of fusion between the two fetuses determines how conjoined twins are categorized.…”

“…Conjoined twins that have dicelike heads are a rare type. Before implantation, the zygote fails to divide at neck level, resulting in the twins fusing below the neck, leading to this uncommon dicephalic head abnormality (Singh et al,. 2017).…”