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

Abstract

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.

Perinatal Complications of Twin Deliveries at Jimma University Specialized Hospital, Southwest Ethiopia: A Facility-based Cohort Study

“…Hospital-based prospective cohort study was conducted in Jimma University Specialized Hospital Steven G. Gabbe et al, and Adams, 2007;2011;Takae et al, 2011;Simpson, Malone, 2012;Mille et al, 2012Mille et al, 2012.…”

Conjoined twins in a triplet pregnancy

“…Recently, development in prenatal medicine facilitates termination of conjoined twins following early diagnosis. Thus, standard approach for managing conjoined twins until term and beyond is unacceptable 8. If there is a limitation in postpartum surgical separation of the twins, termination of pregnancy should be decided regardless of gestational age 4.…”

“…If there is a limitation in postpartum surgical separation of the twins, termination of pregnancy should be decided regardless of gestational age 4. In addition to severity of the case, parents’ social situation, religious and psychological beliefs should be considered in the management of conjoined twins 8. If selective feticide is decided, parents should be informed of complications such as neurological sequelae, subsequent fetal demise or increased miscarriage rate fluctuating from 5% to 10%, that survivor may encounter 2.…”