Management of conjoined twins in Kano, Nigeria: our experience and challenges in a low-resource setting

Mohammad, Mohammad Aminu; Anyanwu, Lofty-John Chukwuemeka; Abdullahi, Lawal; Liadi, Sabi'u; Aji, Sani Ali; Atiku, Mamuda; Hassan, Iffat; Ibrahim, Musa; Abdussalam, Muhammad; Danbatta, Hamish Abdu; Yahuza, Mansur Adamu

doi:10.4103/njbcs.njbcs_16_16

Cited by 2 publications

(2 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Other reports from developing countries also show the diagnosis of conjoined twins may be delayed until the third trimester or even up to the time of labor and delivery. 14,15 Due to the lack of clear local guideline and experience in dealing with condition of this rarity, the exact methods for termination of pregnancy are unavailable. A literature review of methods of pregnancy termination for conjoint twins in second trimester revealed 75% delivered vaginally through medical induction while 18% underwent hysterotomy.…”

Section: Discussionmentioning

confidence: 99%

A rare case of thoraco omphalopagus twins

Prajapati,

Diwan,

Borole

2023

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

Conjoined twins, popularly referred as Siamese twins, are twins joined in utero, affecting less than 1% of the monozygotic pairs. The frequency of conjoined twins has prevalence of 1.5 in 1 lakh births and thoracopagus is the most common. Early diagnosis is important as many patients opt for termination because of the grave prognosis. Though the prognosis of conjoined twin is generally low, there is limited evidence regarding the optimum method of termination of the pregnancy particularly in advanced gestational age. We hereby, report a rare case of successful medical termination of thoraco-omphalopagus twins at 23 weeks and 2 days of gestation. A 27-years old, 2nd gravid woman with previous vaginal delivery diagnosed with conjoined thoraco-omphalopagus twin pregnancy at 23 weeks and 2 days of gestation after the detailed ultrasonographic evaluation. Proper assessment and counselling were done regarding prognosis. Different options of termination were discussed and patient opted for medical termination of pregnancy with possibility of reverting to hysterotomy in case difficulty is encountered. After a 2 day of cervical preparation, a successful vaginal delivery was conducted. Even though this is an experience from a single case, medical termination can be safely preformed in carefully selected cases of conjoined twins beyond 20 weeks of gestation. The adequate cervical preparation, pain control and careful monitoring of the procedure are critical for optimal outcome.

show abstract

Section: Discussionmentioning

confidence: 99%

A rare case of thoraco omphalopagus twins

Prajapati,

Diwan,

Borole

2023

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

show abstract

“…However, as in our case, early diagnosis can be missed and the pregnancy may advance into the second trimester. Other reports from developing countries also show the diagnosis of conjoined twins may be delayed until the third trimester or even up to the time of labor and delivery [ 7 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

Successful dilation and evacuation for second trimester conjoined twin: a case report and review of the literature

et al. 2021

View full text Add to dashboard Cite

Background Conjoined twins are a rare clinical event occurring in about 1 per 250,000 live births. Though the prognosis of conjoined twins is generally low, there is limited evidence as to the optimal method of pregnancy termination, particularly in cases of advanced gestational age. We report a successful dilation and evacuation (D&E) done for conjoined twins at 22 weeks of gestation. Case presentation A 20-year-old primigravid woman was diagnosed with a conjoined, thoraco-omphalopagus twin pregnancy after undergoing a detailed two-dimensional (2D) fetal ultrasound anatomic scanning. Assessment and counseling were done by a multidisciplinary team. The team discussed the prognosis and options of management with the patient. The patient opted for termination of pregnancy. Different options of termination were discussed and the patient consented for D&E, with the possibility of reverting to hysterotomy in case intraoperative difficulty was encountered. A 2-day cervical preparation followed by D&E was done under spinal anesthesia and ultrasound guidance. Conclusion In this patient, D&E was done successfully without complications. Adequate cervical preparation, pain control, and ultrasound guidance during the procedure are critical for optimal outcomes. A literature review of methods of pregnancy termination for conjoined twins in the second trimester revealed 75% delivered vaginally through medical induction while 18% underwent cesarean section. Only one other report described successful D&E for conjoined twins after 20 weeks. D&E can be safely performed for carefully selected cases of conjoined twins beyond 20 weeks’ gestations avoiding the need for induction or hysterotomy.

show abstract

Management of conjoined twins in Kano, Nigeria: our experience and challenges in a low-resource setting

Cited by 2 publications

References 7 publications

A rare case of thoraco omphalopagus twins

A rare case of thoraco omphalopagus twins

Successful dilation and evacuation for second trimester conjoined twin: a case report and review of the literature

Contact Info

Product

Resources

About