Twins Conjoined
Conjoined are identical twins joined in utero. Two contradicting theories exist to explain the origins of conjoined twins.
Conjoined twins
Conjoined twins are two babies who are born physically connected to each other. Conjoined twins develop when an early embryo only partially separates to form two individuals. Twin who share their vital organ and body parts, are referred as conjoined twin. Although two fetuses will develop from this embryo, they will remain physically connected most often at the chest, abdomen or pelvis. many conjoined twins die in the womb or die shortly after birth. Some surviving conjoined twins can be surgically separated.
Symptoms Conjoined twins
There are no specific signs or symptoms that indicate a conjoined twin pregnancy. As with other twin pregnancies, the uterus may grow faster than with a single fetus, and there may be more fatigue, nausea and vomiting early in the pregnancy. They sometimes share organs or other parts of their bodies.
Conjoined twins may be joined at any of these sites:
Chest
Abdomen
Base of spine
Length of spine
Pelvis
Trunk
Head
Head and chest
Diagnosis of Conjoined twins
Conjoined twins can be diagnosed using standard ultrasound as early as the end of the first trimester. More-detailed ultrasounds and echocardiograms can be used about halfway through pregnancy to better determine the extent of the twins’ connection and the functioning of their organs.
Types of Conjoined twins
Thoracopagus
Omphalopagus
Ischiopagus
Parapagus
Craniopagus
Rachipagus
Parasitic twins
Acardiac twins
Diprosopus
Treatment of Conjoined twins
Medical Therapy
Nutritional support is very important in survival of the separated twins, as delayed healing and infections may occur. Parenteral or enteral feedings must be carefully.
Surgical Therapy
Once the diagnosis has been confirmed, the parents should be counseled on the possible outcomes. The delivery should take place close to the surgical unit where the separation will be performed. An elective cesarean delivery should be performed near term after confirmation of fetal lung maturity. Twin delivery may otherwise lead to overdistension and uterine atony.
