Thoracopagus conjoined twin: an unusual presentation

Journal of Nepal Medical Association

Conjoined twins (Siamese twins) represent the rarest form of twin pregnancy. Reported here are two rare cases of conjoined term twins presented to the department of Obstetrics and Gynaecology within 3 months. The first case, 32 years of gravida 6 parity 5 referred from periphery after full trial of labour following multi-organ dysfunction and term intrauterine dead twins. Intraoperatively it was dead conjoined thoraco-omphalopagus females. The patient died after 3 days following multiorgan dysfunction syndrome and disseminated intravascular coagulation. The second case, 22 years gravida 2 parity 1 also referred from periphery in second stage of labour with diagnosis of 39 weeks intrauterine dead twins with obstructed labour, delivered by caesarean with intraoperative conjoined dead females of thoracophagus type. Twins are high-risk pregnancy. This rare diagnosis with complications could have been prevented by regular antenatal checkups, ultrasonography performed by radiologists and ...

Journal of Chitwan Medical College, 2019

A 27 years old primigravida woman at 19 weeks of gestation was came for routine antenatal checkup in Chitwan Medical College was diag­nosed as twin pregnancy with thoracophagus conjoined twin. The fetal biometrics of both were consistent with the gestational age. Fetuses were found with fusion of the skin contour, at the level of the lower chest with complex appearing fused cardiac near midline and liver ap­pears separate. Both fetal heads were in breech presentation facing faces with each other at the same level. Bilateral upper and lower limbs were identified in both fetuses with same gender. The parents decided to terminate the pregnancy but refused autopsy.

Bangladesh Journal of Medical Science, 1970

A patient at her 38+ wks of pregnancy as a ultrasonographically diagnosed case of conjoined twin admitted in our department with ruptured membrane. Two live female babies joined at the chest were delivered by caesarean section. The parents refused a separation operation and the mother and the babies were discharged from hospital at 6th post natal day. A review of the literature suggests that early diagnosis by a combination of ultrasound and MRI is essential for management as it provides prognosis for viability and process of surgical separation and also the opportunity for early counseling of parents and termination if indicated. Key world: Conjoined twins; thoracopagus; prenatal diagnosis; separation procedure DOI: http://dx.doi.org/10.3329/bjms.v10i4.9504 BJMS 2011; 10 (4): 289-292

ISRN Obstetrics and Gynecology, 2011

Objective. Conjoined twin is a rarely seen congenital anomaly together with severe mortality and morbidity. The more common types of conjoined twins include the thoracopagus type, where the fusion is anterior, at the chest, and involves the heart. We are reporting one case of conjoined thoracopagus twins diagnosed by ultrasonography at 11 weeks. Case Report. In a multigravid pregnant woman who has been admitted to our clinic with a diagnosis of conjoined twins, thoracopagus, by ultrasonography at an 11-week gestation, termination of the pregnancy was performed. Conclusion. Making an early diagnosis with ultrasonographic examination gives the parents a chance to elect pregnancy termination.

Medical Science

Conjoined twins are a relatively uncommon congenital anomaly with a significant mortality and morbidity rate. Twins who are conjoined are the thoracopagus variation is one of the most common types of conjoined twins, in which the fusion is anterior, at the chest and affects the heart. We describe a case of a 19 years old primigravida who delivered conjoined twins by thoracopagus. A pregnant woman who had reached full cervical dilatation was admitted to the delivery room. She had an ultrasound, which revealed bigeminal pregnancy with two breech-presented foetuses that were perhaps conjoined twins. The foetus' dimensions determined by ultrasound corresponded to a gestational age of 22 weeks. The first foetus' heart rate was roughly 40 beats per minute, while the second foetus' heart rate was imperceptible. She delivered herself by manually extracting the foetuses. Unable to show any signs of life, one male and one female foetus were delivered. The cause of death was determined by autopsy to be thoracophagus.

2021

Background: Conjoined twins are a rare type of monoamniotic twins, estimated to occur in 1.5 per 100,000 births worldwide [1]. The incidence appears remarkably similar throughout the world, although the report is higher from Atlanta 1 per 20,000 births [2]. When twins are conjoined, the fusion occurs between the same body parts. Conjoined twins are classified as cephalopagus, thoracopagus, omphalopagus, ischiopagus, parapagus, craniopagus, rachipagus and pygopagus based on the site of fusion. Case Report: Here we report a case of a 27-year-old Gravida 4 para 2 Abortion 1 mother who presented with labor and rupture of membrane. She had two previous cesarean deliveries. She did not have ultrasound scanning throughout her pregnancy. She was in active labor and an emergency Cesarean section was done. Conjoined twin (Thoraco-omphalopagus) was diagnosed during surgery when the fetuses were extracted from the uterus intra-operatively. Conclusion: The case of thoraco omphalopagus conjoined ...

Indian Journal of Radiology and Imaging, 2006

International Journal of Advanced Research (IJAR), 2025

Conjoined twins are an extremely rare form of monozygotic twinning, with an estimated incidence of between 1 in 100,000 and 1 in 250,000 live births, and are rarely encountered by obstetricians. Prompt diagnosis and management are essential, as around 70% of conjoined twins die within 48 hours of birth or present with lethal congenital malformations. We report the case of a thoraco-omphalopagus twin pregnancy terminated at 13 weeks amenorrhea.

Case reports in obstetrics and gynecology, 2017

Conjoined twins are very rarely seen. We present a case of thoracopagus that was undiagnosed prior to delivery and combined with eclampsia and obstructed labor in a low-resource setting in sub-Saharan Africa. A 27-year-old pregnant woman was presented to the maternity emergency unit of Princess Christian Maternity Hospital (PCMH) in Freetown at term in labor. Upon admission, the patient was awake and orientated and presented a blood pressure of 180/120 mmHg and a protein value of 3+ on urine dipstick test. Clinical examination-ultrasound was not available-led to the admission diagnosis: obstructed labor with intrauterine fetal death and preeclampsia. Application of Hydralazine 5 mg (i.v.) under close blood pressure monitoring was performed. Under spontaneous progression of labor, one head of the yet unknown conjoined twin was born. The patient developed eclamptic fits. Ceasing of seizures was achieved after implementing the loading dose of the MgSO protocol. A vaginal examination le...

International Journal of Biomedical Research, 2013

Conjoined twins is one of the rarest forms of twin gestation. The reported incidence varies from 1 in every 200 identical twin pregnancies to 1 in 50 000 to 1 in 100 000 live births. Majority of cases reported in literature were diagnosed in first trimester of pregancy and have undergone termination on parents request in view of poor fetal outcome. We report a case of live thoraco omphalopaguspagus conjoined twins, presented at 36 weeks of geatation with breech presentation, weighing 4.2 kg, delivered by elective caesarean section. Babies were sharing heart and greater vessels. Babies were referred to cardio thoracic centre for further evaluation and surgical intervention.Parents were counselled about the possible adverse perinatal outcome.