Materiały źródłowe

• #1 Conjoined twins – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/conjoined-twins/symptoms-causes/syc-20353910

  Conjoined twins may be joined at one of several places. […] Conjoined twins are two babies who are born physically connected to each other. […] Though many conjoined twins are not alive when born (stillborn) or die shortly after birth, advances in surgery and technology have improved survival rates. Some surviving conjoined twins can be surgically separated. The success of surgery depends on where the twins are joined and how many and which organs are shared. It also depends on the experience and skill of the surgical team. […] Pregnancy with conjoined twins is complex and greatly increases the risk of serious complications. Conjoined babies require surgical delivery by cesarean section (C-section). […] Possible complications depend on where the twins are joined, which organs or other parts of the body they share, and the expertise and experience of the health care team. When conjoined twins are expected, the family and the health care team need to discuss in detail the possible complications and how to prepare for them.

• #1 Conjoined Twins | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/conjoined-twins

  Conjoined twins are twins that are born with their bodies physically connected. […] Approximately 75 percent of conjoined twins are joined at least partially in the chest and share organs with one another. […] Doctors at Children’s Hospital of Philadelphia have separated 32 sets of conjoined twins and have managed the care of many others whose separation was not surgically possible. […] A thorough prenatal evaluation is particularly important for conjoined twins, as the location and extent of where the twins are joined and what organs are shared play a crucial role in deciding whether the twins will be separable. […] For the duration of the pregnancy, the Center team will work closely with your referring obstetrician to ensure comprehensive prenatal monitoring. […] Patients carrying conjoined twins have the option of delivering in CHOPs Garbose Family Special Delivery Unit, the world’s first birthing unit dedicated to mothers carrying babies with known birth defects.

• #1 Woman chooses surgery to try to save conjoined twin

  https://www.freep.com/story/news/nation/2015/08/21/conjoined-twins-pregnant-amber-mccullough/32111037/

  Prosen said in an ideal situation, the babies would be stable enough to be delivered and allowed to grow and develop on the outside before separation, but in this case, it would leave little chance for survival. […] Prosen said statistics of conjoined twins are difficult, since many are lost in early pregnancy or families choose to end the pregnancy, but says the most accurate data shows conjoined twins are reported to occur somewhere between 1 in 25,000 to 1 in 80,000 pregnancies, and encompass a half percent of all identical twin pregnancies.

• #1 Conjoined twins – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/conjoined-twins/diagnosis-treatment/drc-20353915

  Conjoined twins can be diagnosed using routine ultrasound as early as 7 to 12 weeks of pregnancy. […] Treatment of conjoined twins depends on their unique situation their health issues, where they’re joined, whether they share organs or other vital structures, and other possible complications. […] If you’re carrying conjoined twins, you’ll likely be closely monitored throughout your pregnancy. […] Your specialists and others on your health care team learn as much as possible about your twins. […] After your conjoined twins are born, they’re fully evaluated. […] If a decision is made to separate the twins, separation surgery is usually done around 6 to 12 months after birth to allow time for planning and preparation. […] Many complex factors must be considered as part of the decision to do separation surgery.

• #1 Conjoined twins: an obstetrician’s guide to prenatal care and delivery management | Journal of Perinatology

  https://www.nature.com/articles/s41372-021-01107-5

  Obstetricians infrequently encounter conjoined twins. Much of the clinical care literature focuses on postnatal management from a neonatology and pediatric surgery perspective; guidance on obstetrical management is limited. We outline steps for prenatal evaluation, obstetrical care, and delivery planning. […] We identified several points throughout the planning, delivery, and postnatal process that are important to highlight for optimizing clinical outcome, patient safety, and parental satisfaction. […] After diagnosis, patients should be referred to a center experienced in the management of conjoined twins. Specialists in fields including maternal fetal medicine, pediatric surgery, neonatology, and radiology play a vital role in the management of these patients. Early referral allows for timely family counseling and decision-making. Prenatal evaluation beyond the first trimester should include a detailed ultrasound, fetal echocardiogram, and fetal MRI. 3D printed life-sized models can improve delivery planning and patient understanding.

• #1 Conjoined Twins: Development, Delivery, and Separation

  https://www.healthline.com/health/conjoined-twins

  Conjoined twins are twins two babies that are physically connected to one another. They may be connected at the chest, abdomen, head, or some other part of the body and often share organs in these areas. […] Conjoined twins are rare and face a number of health challenges before and after birth. If they survive to infancy, some conjoined twins may be surgically separated, depending on how theyre connected and what organs they share. […] Pregnancy with conjoined twins is considered high risk, so youll likely be referred to a maternal-fetal medicine (MFM) specialist or perinatologist for additional support. […] After delivery, the twins may need care in the neonatal intensive care unit (NICU). Experts share that around 25% of conjoined twins survive long enough to be considered for separation surgery.

• #1 Conjoined Twins – Fetal Health Foundation

  https://www.fetalhealthfoundation.org/fetal-syndromes/conjoined-twins/

  Conjoined twin boys are connected by their abdomen before undergoing separation surgery. […] Managing a pregnancy with conjoined twins can feel overwhelming. But learning more and working closely with your team can help you know what to expect and how to advocate for your and your babies best possible care. […] Conjoined twins must always be delivered by C-section, which can carry certain maternal risks including: infection, loss of blood, blood clots, organ injury, risks to future pregnancies, and more. Other risks include miscarriage, preterm birth, and neonatal death. It is important to deliver your babies at a facility that has a wide range of specialized services to ensure the best outcome for you and your babies. […] Depending on where the babies are connected and the extent of organs that are shared, separation surgery can be a viable option. This is a long, delicate, and complex operation with risks to one or both babies involving a large team of doctors and medical professionals. There are usually subsequent reconstructive surgeries required to complete the separation process.

• #1 Conjoined Twins: Types, Causes, Survival & Life Expectancy

  https://www.webmd.com/baby/what-are-conjoined-twins

  Conjoined twins are twins who are physically attached to one another. This condition can cause complications during pregnancy, delivery, and after the babies are born. […] Most conjoined twins need a lot of medical care to help manage their long-term health. […] A pregnancy involving conjoined twins is considered high-risk. It may cause serious complications and requires a team of professionals to manage. If the babies survive, they must be delivered by C-section. […] If your doctors confirm you are pregnant with conjoined twins, they’ll monitor your pregnancy closely. You’ll likely have a team of doctors for you and your babies. […] Most conjoined twins need to be delivered by C-section to lower your risk of complications. […] There will probably be a lot of medical professionals in the delivery room with you, and each twin will have their own medical team, led by a neonatologist.

• #1 Conjoined Twins: Types, Causes, Survival & Life Expectancy

  https://www.webmd.com/baby/what-are-conjoined-twins

  Once your babies are delivered, their cords will be quickly clamped to prevent blood circulation problems. Their team of doctors will examine them and let you know the next steps. […] Not all conjoined twins are good candidates for surgery to separate them. […] Elective separation surgery is very complicated. […] Some conjoined twins don’t have separation surgery and grow into adulthood still conjoined. They usually need special accommodations for transportation and housing as they grow up. […] More conjoined twins are surviving today than in the past, thanks to improvements in imaging studies and surgical techniques.

• #1 Conjoined Twins – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560839/

  Conjoined twins refers to twins that are physically fused in utero and consequently at birth. This type of pregnancy is a complicated phenomenon that requires an interprofessional team approach to manage it effectively. […] This type of pregnancy is a complicated phenomenon that requires an interprofessional approach to manage it effectively. […] The management of conjoined twins requires the intimate cooperation of an interprofessional team. […] Nursing care (maternal) considerations include privacy, grief counseling, if necessary, and providing emotional support to the patient and family. […] An interprofessional team is important to address the challenges of a complicated pregnancy and birth process.

• #1 Nursing considerations and interdisciplinary coordination in the care of conjoined twins – PubMed

  https://pubmed.ncbi.nlm.nih.gov/30185382/

  Traditional nursing care strategies may require modification to meet the unique needs of conjoined twins. Here we discuss the strategies found to be useful in planning for and responding to distinctive circumstances encountered throughout hospitalization, as well as lessons learned. Areas of focus include ensuring privacy, designing adequate unit accommodations to meet space and equipment needs, staffing considerations and adaptations to typical neonatal intensive care nursing interventions. The utility of a team-based approach to interdisciplinary care coordination is also discussed. With adequate preparation and thoughtful innovation, most tertiary neonatal intensive care units can readily adapt to the unique needs of conjoined twins.

• #1 Caring for conjoined twins

  http://journals.rcni.com/nursing-standard/caring-for-conjoined-twins-ns.13.16.14.s31

  Caring for conjoined twins requires the expertise of a multidisciplinary team and nurses are essential as the pivotal point for communication says Donna Liang, who recently nursed conjoined twins at Great Ormond Street Hospital. […] Caring in these unusual circumstances requires a multidisciplinary team approach, each team demonstrating their own expertise but also relying on the expertise of the other teams.

• #1 Conjoined twins – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/conjoined-twins/diagnosis-treatment/drc-20353915

  After separation surgery, pediatric rehabilitation services are crucial to help the twins develop properly. […] If separation surgery isn’t possible or if you decide not to have the surgery done, your team can help you meet the medical care needs of your twins. […] Learning that your unborn twins have a major medical issue or life-threatening condition can be devastating. […] If you’re pregnant with conjoined twins, you’ll be referred to a team of specialists to help guide you and create a treatment plan for your twins. […] Your health care provider and other members of your health care team review your conjoined twins’ tests and exam results and discuss options with you.

• #1 Conjoined twins – Hancock Health

  https://www.hancockhealth.org/mayo-health-library/conjoined-twins/

  Conjoined twins require surgical delivery by cesarean section (C-section). […] Conjoined babies are likely to be born prematurely, and one or both could be stillborn or die shortly after birth. […] Possible complications depend on where the twins are joined, which organs or other parts of the body they share, and the expertise and experience of the health care team. […] If you’re carrying conjoined twins, you’ll likely be closely monitored throughout your pregnancy. […] Your specialists and others on your health care team learn as much as possible about your twins. […] After your conjoined twins are born, they’re fully evaluated. […] If a decision is made to separate the twins, separation surgery is usually done around 6 to 12 months after birth to allow time for planning and preparation.

• #1 Families celebrate GOSH’s Conjoined Twins Day | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/news/families-celebrate-goshs-conjoined-twins-day/

  Six sets of twins came together to be seen by their different teams on Great Ormond Street Hospitals Conjoined Twins Day. […] The Specialist Neonatal and Paediatric Surgery (SNAPS) team arranged the day so that the twins and their families had chance to meet each other, and in some cases be reunited. […] Since then, over 38 sets of conjoined twins have been cared for at GOSH separating more twins than anywhere in the world. […] The teams also include dedicated paediatricians, ward nurses and allied health professionals including physiotherapists, occupational therapists, dietitians, speech and language therapists, and the Play team, who all perform a vital part in the care and rehabilitation following the operations. […] Its impossible to list all those involved in their care, but were lucky that GOSH is one of the few places in the world that has so many skilled teams under one roof to separate conjoined twins and give them the best possible treatment.

• #1 Conjoined Twin Girls Separated at Cook Children’s

  https://www.checkupnewsroom.com/we-did-it-conjoined-twin-girls-separated-at-cook-childrens-medical-center-make-history/

  Sisters JamieLynn and AmieLynn underwent surgery on Monday, becoming the first conjoined twins to be separated at Cook Childrens Medical Center. […] After the surgery, the girls returned to Cook Childrens NICU to begin their journey to recovery, this time on the road together, but separate. […] Doctors are optimistic as the girls heal. Their primary focus will be breathing support and pain control in the next few days. […] Many conjoined twins die in utero or do not survive long after birth because of the nature of their joining and the organs they share. But scans showed JamieLynn and AmieLynn each had their own heart and heart sac, increasing their chance of survival and making them candidates for future separation. […] The timing of conjoined twin division varies from case to case and primarily depends on how complicated the anatomy is. In the girls case, their anatomy and growth support a surgery date sooner rather than later.

• #1 Conjoined Twin Girls Separated at Cook Children’s

  https://www.checkupnewsroom.com/we-did-it-conjoined-twin-girls-separated-at-cook-childrens-medical-center-make-history/

  The surgery comes with great risk and a number of unknowns. Because they must dissect the liver, an extremely vascular organ, bleeding is a concern. A significant risk of infection also exists, for which the twins will be monitored weeks into recovery. […] Recovery is best described as slow. […] Theyll need extensive rehabilitation, too, which will include nutritionists, physical therapists, occupational therapists, speech therapists and more. […] Doctors say theyre optimistic but will continue to hold their collective breath until they are waving goodbye to the girls as they leave Cook Childrens for their first ride home.

• #1 Conjoined Twins: Development, Delivery, and Separation

  https://www.healthline.com/health/conjoined-twins

  That said, separation depends on where the twins are joined and which vital organs are shared. This means that some twins may be separated while others cant be separated. […] Separation surgery is undergone on a case-by-case basis when the twins are between 3 months old and 3 years old. No two surgeries are alike, and they bring their own individual risks and ethical questions. Youll work closely with your doctor to determine the right choice in your case. […] Theres no standard treatment for conjoined twins. Instead, your doctor will take into consideration the babies health and any other special circumstances that are unique to their physical connection. […] Youll likely have a team made of many different medical doctors who can advise you on the next steps to help your twins with health issues, development, and other areas.

• #1 Conjoined Twins | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/conjoined-twins

  A comprehensive post-delivery assessment will determine the long-term plan for a potential separation surgery. […] If the conjoined twins are candidates for separation surgery, CHOPs pediatric surgical team will work with a multidisciplinary team to monitor the babies and determine the timeline and approach for the surgical procedure. […] When the conjoined twins share a heart, successful surgical division is usually not possible. […] Since 1995, 133 pairs of conjoined twins have been referred to the Center for Fetal Diagnosis and Treatment, and 72 pairs have undergone prenatal evaluation. […] Childrens Hospital of Philadelphia has successfully separated 32 pairs of conjoined twins, the first in 1957.

• #1 3D technology helps separate conjoined twins | College | College of Science and Engineering

  https://cse.umn.edu/college/news/3d-technology-helps-separate-conjoined-twins

  Five doctors stand in front of a large screen with a small group of engineers, staring in silence. […] The girls doctors knew the only way to successfully care for the babies and their mother from prenatal care, to birth, to separation and after, was to have a team-oriented approach. […] The surgical team also met several times in the operating room for simulations, or practice runs, of the operation. […] The surgeons were able to explore the twins anatomy and make the appropriate plan before the procedure began. […] The surgeons agree. For starters, that technology coupled with 3-D models of the babies hearts revealed what they couldnt see before: an actual physical connection bridging the two girls hearts. […] Fortunately, it was recognized, and that allowed the team to better prepare for the surgery adapting their approach to accommodate the complexities unique to Paisleigh and Paislyn.

• #1 Inside the Successful Separation Surgery of Conjoined Twins | Columbia University Irving Medical Center

  https://www.cuimc.columbia.edu/news/inside-successful-separation-surgery-conjoined-twins

  Throughout the early months, Alusine and Isatu searched for the best surgical options for their twin girls. […] To prepare for the complex separation procedure, the multidisciplinary team held meetings and surgery simulations to map out the steps of the well-choreographed separation surgery. […] The care team performed a series of surgeries to ensure the optimal placement and performance of Chelseas heart inside her new body and to repair the area of pericardial lining that she was missing. […] Throughout it all, the twins remained by each others side. In the pediatric ICU, the girls were put in individual but adjacent rooms. […] After the twins were discharged, Chelsea and Maggie continued to receive follow-up care at the hospital. […] In terms of their gross motor skills, their development was delayed because of the connection through the abdomen and their prolonged hospitalization, says Martinez. But they are now walking after receiving intense occupational and physical therapies.

• #1 Conjoined twins – twenty years’ experience at a reference center in Brazil | Clinics

  https://www.elsevier.es/en-revista-clinics-22-articulo-conjoined-twins-twenty-years–S1807593222020762

  OBJECTIVE This study reports on the experience of one hospital regarding the surgical aspects, anatomic investigation and outcomes of the management of 21 conjoined twin pairs over the past 20 years. […] A detailed anatomic study of the twins and surgical planning must precede separation. A well-prepared pediatric surgery team is sufficient to surgically manage conjoined twins. […] The surgical separation of conjoined twins is now the principal aim of all medical teams who treat this uncommon condition. However, separation presents both surgical and anesthetic challenges. […] In Brazil, when a diagnosis of conjoined twinning is made, the pregnant mother is usually referred to a tertiary hospital that specializes in obstetric and perinatal care. […] The separation procedure was always performed by a single surgical team. After the separation, the second twin was moved with the corresponding anesthetic equipment and a second team of surgeons to another surgical room for the final reconstruction procedures.

• #1 Formerly Conjoined Twins Admitted to Blythedale | Blythedale Children’s Hospital

  https://www.blythedale.org/news-media/formerly-conjoined-twins-admitted-blythedale

  Blythedale Childrens Hospital announced today that formerly conjoined twins Jadon and Anias McDonald have been admitted to the Hospitals Infant Toddler Unit for comprehensive rehabilitation. […] The boys, following evaluation by their new clinical care teams at Blythedale, will be immersed in a daily regimen of physical, occupational, speech and feeding therapy. […] They will receive post-surgical medical management, provided by specialists in pediatrics, neonatalogy, physical medicine and rehabilitation, nursing, social work, Child Life, and the Hospitals developmental specialists. […] „Jadon and Anias came into Blythedale as two individuals each with their own unique capabilities and needs. The team will develop a care plan tailored specifically to each but they will share this experience as brothers.”

• #1 32nd set of conjoined twins successfully separated at CHOP

  https://www.fetalhealthfoundation.org/uncategorized/conjoined-twins-now-separated-are-thriving-and-excited-to-go-home-with-their-family/

  Parents and older siblings happily hold the hands of little brothers, following the surgery to separate the conjoined twins. […] Maternal-fetal medicine specialist Dr. Nahla Khalek worked with genetic counselors, radiologists, neonatologists, psychologists, surgeons, nurses and other members of the Centers comprehensive team to carefully monitor Shanekas pregnancy. […] From the moment families receive their fetal diagnosis, the psychosocial team members provide compassionate, individualized care for the entire family. […] The team of specialists had been preparing for that day since Amari and Javar were born. […] Amari and Javar are working with occupational, physical, music and play therapists, plus a speech therapist who helps with feeding. […] Shaneka and Tim are getting comfortable with caring for the boys as they continue to heal and learn to do things like flip over, lie on their stomachs, and crawl.

• #1 Conjoined Twins – Seattle Children’s

  https://www.seattlechildrens.org/conditions/conjoined-twins/

  More conjoined twins survive now than in the past. This is a result of advances in imaging studies, surgical techniques and anesthesia. […] Our treatment goal is to give both children the best chance for a good quality of life. Sometimes surgery to separate the twins is the best option. The success of the separation surgery depends on many factors, mainly where the twins are connected and which structures they share. […] Sometimes separation surgery is not possible. Some conjoined twins have happy, healthy, full lives by staying connected. […] Your babies treatment will depend on the health of each twin and how they are joined. […] Treatment for each set of twins is unique. The connection between the twins bodies may range from fairly simple to very complex. […] Your twins healthcare team will do tests during pregnancy and after birth to learn as much as they can about your babies anatomies and how well their bodies are working. The team uses this information to create a detailed treatment plan. Our goal is to give both children the best chance for a good quality of life, whenever possible.

• #1 Conjoined Twins – Care Options for Kids

  https://careoptionsforkids.com/blog/conjoined-twins

  Conjoined twins require the highest levels of personalized care and attention to ensure the healthiest and best possible outcomes. No two cases are ever alike, and the situation can change depending on where the two babies are joined, which organs they share, and any related complications that may have developed. […] Conjoined twins will have extensive care needs throughout life. Depending on circumstances, conjoined twins may require assistance with mobility, nutrition, dressing, and other daily needs. Additionally, conjoined twins can expect to require ongoing medical attention to assess complications and monitor for potential problems that may arise. […] A large number of families with conjoined twins require or benefit from the assistance of home health professionals. Some cases require constant support from highly specialized services while other families may need more limited help. A qualified and experienced home health agency can work to design a care plan that fits any family’s needs.

• #1 Conjoined Twins: Definition, Causes & Outlook

  https://my.clevelandclinic.org/health/diseases/22895-conjoined-twins

  Conjoined twins are rare. Complications can be reduced with close management from healthcare professionals. […] Delivery by C-section is the most common way to manage this situation. […] Successful management usually involves several medical and surgical specialists. […] The decision to attempt separation or not can bring up difficult ethical questions. […] In some cases, it’s possible to separate conjoined twins. […] The procedure to separate twins always takes extensive planning by a team of highly experienced surgeons. […] Many healthcare providers feel that surgical separation should take place when conjoined twins are 9 to 12 months old. […] Healthcare providers can manage complications to improve the outlook for conjoined twins. […] Some conjoined twins who can’t be separated can still enjoy a good quality of life if they’re closely monitored.

• #1 Conjoined twins connected at the heart and liver successfully separated at UF Health – UF Health

  https://ufhealth.org/news/2016/conjoined-twins-connected-heart-and-liver-successfully-separated-uf-health

  Conjoined twins connected at the heart, sternum, diaphragm and liver were recently successfully separated, and now are preparing to go home. […] The twins shared a connection at the upper chamber of the heart, called the atrium, where blood enters the heart. […] It became a very challenging planning process for us, and, ultimately, a challenging separation. […] Co-Vu and the team used cardiac CT and MRI scans before and after the twins were born to create what appears to be the first-ever 3-D printed conjoined twin heart. […] The team which included Co-Vu, Bleiweis and many others from the pediatric cardiac intensive care unit, radiology, neonatology, maternal fetal medicine, anesthesiology and plastic surgery met numerous times to create the preoperative plan for the twins, to practice the separation itself and to manage the twins care after the surgery.

• #1 Conjoined Twin Types and Treatment

  https://www.verywellhealth.com/conjoined-twins-5210361

  Conjoined twins are always identical twins. […] Carrying conjoined twins can cause additional pregnancy risks such as preterm birth and delivery by cesarean section, or C-section. […] There are many factors that go into a decision to perform separation surgery, including the extent of shared organs and the surgeries that will be required to reconstruct body parts after separation surgery. […] Not all conjoined twins are candidates for surgery, such as when the babies share a heart. […] Preparation for separation surgery can be critical. […] Between 50% and 90% of separation surgeries are successful but it depends on the organs involved. […] However, continuing advances in surgical procedures have led to successful separation surgeries. […] It’s equally important to consider physical therapy, occupational therapy, mental health treatment, and other services that may be part of conjoined twin care.

• #1 Conjoined twins separated by UofL pediatric surgical team — School of Medicine University of Louisville

  https://louisville.edu/medicine/news/conjoined-twins-separated-by-uofl-pediatric-surgeon

  Conjoined twin girls were separated by UofL physicians on Nov. 11. […] Specialists with University of Louisville Physicians have announced they performed a surgery to separate 7-week-old conjoined twin girls on Nov. 11 at Kosair Childrens Hospital. […] Since the surgery, the girls have been under close watch of experts in the hospitals Just for Kids Critical Care Center. […] Their long-term prognosis is not yet known, but indicators are favorable for continued improvement. […] In any situation where you have so complex a surgery, there is always a long road to recovery, said Erle H. Austin III, M.D., pediatric surgeon with UofL Physicians and the UofL School of Medicine’s Department of Cardiovascular Surgery. […] We are cautiously optimistic, as one or both may require additional surgeries in the future.

• #1 Advancing healthcare for conjoined twins and children with disabilities | UNICEF

  https://www.unicef.org/partnerships/announcements/conjoined-twins

  Advancing inclusive healthcare for all […] The recent designation of 24 November as the International Day of Conjoined Twins by the United Nations General Assembly is a crucial step towards raising awareness and strengthening global efforts to support children with complex medical needs. Conjoined twins face extraordinary health challenges, requiring specialized medical expertise, long-term care and social inclusion. […] Empower families with holistic support: Providing not only medical care but also psychological, financial and social support for families navigating complex medical conditions. […] Strengthen equitable healthcare systems for all: Expanding universal health coverage to ensure that every child, including those with complex medical needs, has access to specialized pediatric and rehabilitative care, free from discrimination or barriers to inclusion.

• #1 Conjoined Twins | Children’s Hospital Colorado

  https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/conjoined-twins/

  Conjoined twins can be delivered by cesarean section at our state-of-the-art facility, where our team specializes in managing this condition. […] Our fetal experts also have experience in procedures to surgically separate the twins after birth. […] Treatment options for conjoined twins varies from case to case. The Colorado Fetal Care Center works closely with the parents to identify the best treatment plan for their babies. […] Conjoined twin treatment options vary based on where and how the babies are joined. […] Twins whose lives are immediately threatened, especially those connected at the chest or head, require emergency surgery before extensive diagnostics can be completed. […] Significant ethical considerations arise in cases where it is not possible to achieve separation without sacrificing the life or the quality of the life of one of the two twins. […] Your physicians will assess your case with a high degree of detail through multiple diagnostic tests and create a treatment plan aimed at maximizing your children’s health and quality of life.

• #1 Doctors talk about ethical decisions, surgery on conjoined twins | Association of Health Care Journalists

  https://healthjournalism.org/blog/2017/12/doctors-talk-about-ethical-decisions-surgery-on-conjoined-twins/

  The twin girls were joined at the abdomen and pelvis. They had two heads and four arms, but three legs. They had two hearts, but shared a liver, a bladder, and other organs. […] The team determined that separation was feasible, but that only one of the twins would survive. That raised a host of ethical and moral questions, said Dr. Brian M. Cummings, chair of the hospitals Pediatric Ethics Committee. Among the issues they debated: Were the conjoined twins one person or two? Can doctors ever, morally or ethically, sacrifice one for the other? And who should decide the doctors or the parents? […] Some of the medical staff objected to intervening, saying they cant do harm and must let nature take its course, Cummings said. […] In the end, just three doctors chose not to participate in the surgery because of their discomfort.

• #1 Conjoined Twins | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/81614

  During medical management, some pharmacokinetic considerations must be kept in mind as the shared circulation of the conjoined twins may have a variable volume of distribution and clearance. […] Prenatal counseling of the family plays an important role because of the complicated nature of management and prognosis. […] Timing and mode of delivery should be individualized, taking into consideration any antenatal complications and the altered anatomy based on prenatal imaging. […] An interprofessional team is important to address the challenges of a complicated pregnancy and birth process. […] Nutrition support is very important in the management of conjoined twins during the neonatal period. […] Conjoined twins should be cared for at specialized centers with MFM, neonatal intensive care unit (NICU) and pediatric subspecialty availability.

• #1 Conjoined Twins – Greater Accra Regional Hospital

  https://garh.gov.gh/conjoined-twins/

  The video shows a simulation exercise ahead of planned surgery for Conjoined Twins connected at the head. A team of Nurses from Ghana’s biggest hospitals assembled at the Greater Accra Regional Hospital, Ridge. […] Doctors at the Greater Accra Regional Hospital (GARH) have separated 25 sets of conjoined twins and have managed the care of many others whose separation was not surgically possible. […] Expectant mothers visiting the Center for Fetal Diagnosis and Treatment at GARH will undergo a full day of advanced imaging to collect a detailed picture of the shared organs and any associated anomalies. Prenatal diagnosis will help identify the optimal treatment and delivery plan, and potential for separation after birth. […] For the duration of the pregnancy, the Center team will work closely with your referring obstetrician to ensure comprehensive prenatal monitoring. In some cases, care will be transferred to the Center around 28 weeks’ gestation or earlier to optimize management of the pregnancy and prepare for delivery.

• #1 Conjoined Twins | Pediatric Surgery NaT

  https://www.pedsurglibrary.com/apsa/view/Pediatric-Surgery-NaT/829673/13/Conjoined_Twins

  Conjoined twins are perhaps the most complex pediatric surgical patients. Because they are also rare, it is also likely that a single pediatric surgeon will take care of very few of them or none at all. Therefore, extensive study of the literature and understanding of patient anatomy and embryology is essential to providing a good outcome. Care of these infants can be both the highlight and greatest challenges of ones career. […] It is also crucial to consider that separation is a team effort. While in the past a single surgeon may have taken on these cases and dealt with both babies, the complexities of union and the specifics of separation call for expertise in a number of areas including general, thoracic, cardiac, orthopedic, urologic, neurosurgical and plastic surgery. Careful coordination of services in neonatology, radiology and even media control are essential to providing care for these infants. One person needs to be the lead surgeon and coordinate all of the facets of care that come into play.

• #1 Families celebrate GOSH’s Conjoined Twins Day | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/news/families-celebrate-goshs-conjoined-twins-day/

  They were born sharing everything except their hearts. Since the day they were separated the twins have excelled everyones expectations. […] The boys also want to be like big brothers for the other twins so they can talk to someone who understands, support them and encourage them to let nothing hold them back. […] GOSH Charity has supported pioneering research that has helped GOSH treat more cases of conjoined twins than any other hospital in the world.

• #1 Inside the Successful Separation Surgery of Conjoined Twins | Columbia University Irving Medical Center

  https://www.cuimc.columbia.edu/news/inside-successful-separation-surgery-conjoined-twins

  More than a year after their separation surgery, the girls are thriving. They are growing and making progress in achieving developmental milestones, says Martinez. They both have an opportunity to go forward from here, reaching new heights individually, each as her own person, which never could have been possible without the separation surgery.

• #2 Conjoined Twins: Development, Delivery, and Separation

  https://www.healthline.com/health/conjoined-twins

  Conjoined twins are twins two babies that are physically connected to one another. They may be connected at the chest, abdomen, head, or some other part of the body and often share organs in these areas. […] Conjoined twins are rare and face a number of health challenges before and after birth. If they survive to infancy, some conjoined twins may be surgically separated, depending on how theyre connected and what organs they share. […] Pregnancy with conjoined twins is considered high risk, so youll likely be referred to a maternal-fetal medicine (MFM) specialist or perinatologist for additional support. […] After delivery, the twins may need care in the neonatal intensive care unit (NICU). Experts share that around 25% of conjoined twins survive long enough to be considered for separation surgery.

• #2 Mayo Clinic Health Library – Conjoined twins | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20194203

  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. […] Though many conjoined twins are not alive when born (stillborn) or die shortly after birth, advances in surgery and technology have improved survival rates. […] Some surviving conjoined twins can be surgically separated. […] The success of surgery depends on where the twins are joined and how many and which organs are shared. […] It also depends on the experience and skill of the surgical team. […] Pregnancy with conjoined twins is complex and greatly increases the risk of serious complications. […] Conjoined babies require surgical delivery by cesarean section (C-section). […] Possible complications depend on where the twins are joined, which organs or other parts of the body they share, and the expertise and experience of the health care team.

• #2 Conjoined Twins Story | Wolfson Children’s | Jacksonville, FL

  https://www.wolfsonchildrens.com/services/gastroenterology/twins-gastro-story

  Carter and Conner, conjoined twin boys born Dec. 2014, in Jacksonville, Fla., underwent a successful 12-hour separation surgery in May 2015. […] Leading up to the surgery, the twins integrated care team spent months preparing for the complexities of this separation, including MRI studies, a medical illustration of the conjoined areas, clinical and logistical simulations of the final separation surgery and specific procedures, and keeping the boys as healthy and strong as possible considering their multiple medical challenges. […] From the day after their birth to the morning of their final separation surgery, Carter and Conner received care in Wolfson Childrens Hospitals Level III Neonatal Intensive Care Unit (NICU). […] During their stay, the boys were cared for by nearly 200 health care professionals that included neonatal and pediatric critical care nurses, pediatric respiratory therapists, rehabilitation therapists, Child Life specialists, pediatric chaplains and other health care disciplines. […] Conjoined twins are extremely rare, with estimates ranging from one in every 100,000 births to one in every 200,000 births.

• #2 Conjoined Twins | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/conjoined-twins

  Conjoined twins are twins that are born with their bodies physically connected. […] Approximately 75 percent of conjoined twins are joined at least partially in the chest and share organs with one another. […] Doctors at Children’s Hospital of Philadelphia have separated 32 sets of conjoined twins and have managed the care of many others whose separation was not surgically possible. […] A thorough prenatal evaluation is particularly important for conjoined twins, as the location and extent of where the twins are joined and what organs are shared play a crucial role in deciding whether the twins will be separable. […] For the duration of the pregnancy, the Center team will work closely with your referring obstetrician to ensure comprehensive prenatal monitoring. […] Patients carrying conjoined twins have the option of delivering in CHOPs Garbose Family Special Delivery Unit, the world’s first birthing unit dedicated to mothers carrying babies with known birth defects.

• #2 Conjoined Twins – Greater Accra Regional Hospital

  https://garh.gov.gh/conjoined-twins/

  The video shows a simulation exercise ahead of planned surgery for Conjoined Twins connected at the head. A team of Nurses from Ghana’s biggest hospitals assembled at the Greater Accra Regional Hospital, Ridge. […] Doctors at the Greater Accra Regional Hospital (GARH) have separated 25 sets of conjoined twins and have managed the care of many others whose separation was not surgically possible. […] Expectant mothers visiting the Center for Fetal Diagnosis and Treatment at GARH will undergo a full day of advanced imaging to collect a detailed picture of the shared organs and any associated anomalies. Prenatal diagnosis will help identify the optimal treatment and delivery plan, and potential for separation after birth. […] For the duration of the pregnancy, the Center team will work closely with your referring obstetrician to ensure comprehensive prenatal monitoring. In some cases, care will be transferred to the Center around 28 weeks’ gestation or earlier to optimize management of the pregnancy and prepare for delivery.

• #2 Conjoined twins – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/conjoined-twins/diagnosis-treatment/drc-20353915

  Conjoined twins can be diagnosed using routine ultrasound as early as 7 to 12 weeks of pregnancy. […] Treatment of conjoined twins depends on their unique situation their health issues, where they’re joined, whether they share organs or other vital structures, and other possible complications. […] If you’re carrying conjoined twins, you’ll likely be closely monitored throughout your pregnancy. […] Your specialists and others on your health care team learn as much as possible about your twins. […] After your conjoined twins are born, they’re fully evaluated. […] If a decision is made to separate the twins, separation surgery is usually done around 6 to 12 months after birth to allow time for planning and preparation. […] Many complex factors must be considered as part of the decision to do separation surgery.

• #2 Conjoined twins – Hancock Health

  https://www.hancockhealth.org/mayo-health-library/conjoined-twins/

  Conjoined twins require surgical delivery by cesarean section (C-section). […] Conjoined babies are likely to be born prematurely, and one or both could be stillborn or die shortly after birth. […] Possible complications depend on where the twins are joined, which organs or other parts of the body they share, and the expertise and experience of the health care team. […] If you’re carrying conjoined twins, you’ll likely be closely monitored throughout your pregnancy. […] Your specialists and others on your health care team learn as much as possible about your twins. […] After your conjoined twins are born, they’re fully evaluated. […] If a decision is made to separate the twins, separation surgery is usually done around 6 to 12 months after birth to allow time for planning and preparation.

• #2 Conjoined Twins | Children’s Hospital Colorado

  https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/conjoined-twins/

  Conjoined twins can be delivered by cesarean section at our state-of-the-art facility, where our team specializes in managing this condition. […] Our fetal experts also have experience in procedures to surgically separate the twins after birth. […] Treatment options for conjoined twins varies from case to case. The Colorado Fetal Care Center works closely with the parents to identify the best treatment plan for their babies. […] Conjoined twin treatment options vary based on where and how the babies are joined. […] Twins whose lives are immediately threatened, especially those connected at the chest or head, require emergency surgery before extensive diagnostics can be completed. […] Significant ethical considerations arise in cases where it is not possible to achieve separation without sacrificing the life or the quality of the life of one of the two twins. […] Your physicians will assess your case with a high degree of detail through multiple diagnostic tests and create a treatment plan aimed at maximizing your children’s health and quality of life.

• #2 Conjoined Twins: Types, Causes, Survival & Life Expectancy

  https://www.webmd.com/baby/what-are-conjoined-twins

  Once your babies are delivered, their cords will be quickly clamped to prevent blood circulation problems. Their team of doctors will examine them and let you know the next steps. […] Not all conjoined twins are good candidates for surgery to separate them. […] Elective separation surgery is very complicated. […] Some conjoined twins don’t have separation surgery and grow into adulthood still conjoined. They usually need special accommodations for transportation and housing as they grow up. […] More conjoined twins are surviving today than in the past, thanks to improvements in imaging studies and surgical techniques.

• #2 Nursing considerations and interdisciplinary coordination in the care of conjoined twins – PubMed

  https://pubmed.ncbi.nlm.nih.gov/30185382/

  Traditional nursing care strategies may require modification to meet the unique needs of conjoined twins. Here we discuss the strategies found to be useful in planning for and responding to distinctive circumstances encountered throughout hospitalization, as well as lessons learned. Areas of focus include ensuring privacy, designing adequate unit accommodations to meet space and equipment needs, staffing considerations and adaptations to typical neonatal intensive care nursing interventions. The utility of a team-based approach to interdisciplinary care coordination is also discussed. With adequate preparation and thoughtful innovation, most tertiary neonatal intensive care units can readily adapt to the unique needs of conjoined twins.

• #2 Caring for conjoined twins

  http://journals.rcni.com/nursing-standard/caring-for-conjoined-twins-ns.13.16.14.s31

  Caring for conjoined twins requires the expertise of a multidisciplinary team and nurses are essential as the pivotal point for communication says Donna Liang, who recently nursed conjoined twins at Great Ormond Street Hospital. […] Caring in these unusual circumstances requires a multidisciplinary team approach, each team demonstrating their own expertise but also relying on the expertise of the other teams.

• #2

  https://journals.lww.com/pccmjournal/FullText/2014/05001/ABSTRACT_153__NURSING_CARE_IN_THORACO_OMPHALOPAGUS.150.aspx

  Conjoined twins are more common among girls. Conjunction usually occurs in thoracic region. Treatment possibility in thoraco-abdominal conjoined twins depends on the anatomy of cardiovascular system. Surgical intervention involves sacrificing one of the twins in order to save the other. […] The aim of this study is to share the nursing experience on thoraco-omphalopagus conjoined twins, which have difficulties regarding nursing care. […] Therefore their care should be given by trained and experienced nurses, and feelings and thoughts of the family should be shared.

• #2 Separation of Conjoined Twins – UF Health

  https://ufhealth.org/news/2016/separation-conjoined-twins

  When Jacquelyn was 20 weeks pregnant, she and her partner, Mark, visited her obstetrician to have an ultrasound to find out the sex of their baby. […] The twins were also conjoined at the liver, diaphragm and sternum. […] Surgery can be performed to separate conjoined twins, but survival in the case of conjoined hearts is extremely rare. […] Dr. Co-Vu studied the anatomy of the conjoined twins during an hourlong session of imaging studies, and in particular the anatomy of the two hearts and how they were connected. […] After careful prenatal care by the maternal-fetal medicine team, Scarlett and Savannah were born in April 2016 at 35 5/7 weeks gestation via C-section at the UF Health Shands obstetrical unit. […] They were transferred to the neonatal intensive care unit, where the physiology of their conjoined hearts, diaphragms and a single large liver was managed in a way that allowed them to develop sufficiently to allow surgical separation.

• #2 Conjoined at Birth, Now SeparatedDriscoll Children’s on FacebookDriscoll Children’s on InstagramDriscoll Children’s on TwitterVisit our LinkedInVisit our YouTube channelsearchchevron-rightchevron-upphoneangle-downcrosslinkedinfacebookpinterestyoutubersstw

  https://driscollchildrens.org/conjoined-at-birth-now-separated-8-amazing-years-later/

  No one at Driscoll Children’s Hospital had ever attempted such a complicated procedure. After many months of intense preparation, 14 physicians and a staff of medical professionals were ready to do whatever possible to offer the hope of a normal life to the conjoined twins. […] Teamwork — between the physicians, nurses and other Driscoll Children’s Hospital staff members — made all the difference in the care of Scarlett and Ximena and their identical sister Catalina, who was born without serious health issues. Driscoll’s involvement began early, before the triplets were born, with Driscoll Health System’s Maternal Fetal Medicine Specialists closely monitoring their mother’s progress and delivering the babies. Shortly after their birth on May 16, 2015, the babies were transported to Driscoll Children’s Hospital’s Neonatal Intensive Care Unit (NICU), where Scarlett and Ximena remained until their separation surgery.

• #2 Conjoined Twin Girls Separated at Cook Children’s

  https://www.checkupnewsroom.com/we-did-it-conjoined-twin-girls-separated-at-cook-childrens-medical-center-make-history/

  The surgery comes with great risk and a number of unknowns. Because they must dissect the liver, an extremely vascular organ, bleeding is a concern. A significant risk of infection also exists, for which the twins will be monitored weeks into recovery. […] Recovery is best described as slow. […] Theyll need extensive rehabilitation, too, which will include nutritionists, physical therapists, occupational therapists, speech therapists and more. […] Doctors say theyre optimistic but will continue to hold their collective breath until they are waving goodbye to the girls as they leave Cook Childrens for their first ride home.

• #2 Conjoined Twin Types and Treatment

  https://www.verywellhealth.com/conjoined-twins-5210361

  Conjoined twins are always identical twins. […] Carrying conjoined twins can cause additional pregnancy risks such as preterm birth and delivery by cesarean section, or C-section. […] There are many factors that go into a decision to perform separation surgery, including the extent of shared organs and the surgeries that will be required to reconstruct body parts after separation surgery. […] Not all conjoined twins are candidates for surgery, such as when the babies share a heart. […] Preparation for separation surgery can be critical. […] Between 50% and 90% of separation surgeries are successful but it depends on the organs involved. […] However, continuing advances in surgical procedures have led to successful separation surgeries. […] It’s equally important to consider physical therapy, occupational therapy, mental health treatment, and other services that may be part of conjoined twin care.

• #2 Inside the Successful Separation Surgery of Conjoined Twins | Columbia University Irving Medical Center

  https://www.cuimc.columbia.edu/news/inside-successful-separation-surgery-conjoined-twins

  Throughout the early months, Alusine and Isatu searched for the best surgical options for their twin girls. […] To prepare for the complex separation procedure, the multidisciplinary team held meetings and surgery simulations to map out the steps of the well-choreographed separation surgery. […] The care team performed a series of surgeries to ensure the optimal placement and performance of Chelseas heart inside her new body and to repair the area of pericardial lining that she was missing. […] Throughout it all, the twins remained by each others side. In the pediatric ICU, the girls were put in individual but adjacent rooms. […] After the twins were discharged, Chelsea and Maggie continued to receive follow-up care at the hospital. […] In terms of their gross motor skills, their development was delayed because of the connection through the abdomen and their prolonged hospitalization, says Martinez. But they are now walking after receiving intense occupational and physical therapies.

• #2 Conjoined twins – twenty years’ experience at a reference center in Brazil | Clinics

  https://www.elsevier.es/en-revista-clinics-22-articulo-conjoined-twins-twenty-years–S1807593222020762

  Among the 21 sets of conjoined twins, 12 underwent separation surgery (seven ischiopagus, three omphalopagus, one thoracopagus and one craniopagus). […] The separation procedure began by making a large longitudinal incision across the anterior abdominal wall. […] The reconstruction phase for each separated twin was performed by a reconstruction of the digestive system with intestinal anastomoses, followed by reimplantation of the divided ureters. […] The last phase of reconstruction was the closure of the abdominal wall. […] The surgical mortality rate of our series was 33.3%, which is in accordance with other published series. […] Considering the surgical outcomes, it is concluded that a well-prepared pediatric surgery team is sufficient for the surgical management of conjoined twins.

• #2 Conjoined twins – Hancock Health

  https://www.hancockhealth.org/mayo-health-library/conjoined-twins/

  Many complex factors must be considered as part of the decision to do separation surgery. […] After separation surgery, pediatric rehabilitation services are crucial to help the twins develop properly. […] If separation surgery isn’t possible or if you decide not to have the surgery done, your team can help you meet the medical care needs of your twins. […] Learning that your unborn twins have a major medical issue or life-threatening condition can be devastating. […] If you’re pregnant with conjoined twins, you’ll be referred to a team of specialists to help guide you and create a treatment plan for your twins. […] Your health care provider and other members of your health care team review your conjoined twins tests and exam results and discuss options with you.

• #2 32nd set of conjoined twins successfully separated at CHOP

  https://www.fetalhealthfoundation.org/uncategorized/conjoined-twins-now-separated-are-thriving-and-excited-to-go-home-with-their-family/

  Parents and older siblings happily hold the hands of little brothers, following the surgery to separate the conjoined twins. […] Maternal-fetal medicine specialist Dr. Nahla Khalek worked with genetic counselors, radiologists, neonatologists, psychologists, surgeons, nurses and other members of the Centers comprehensive team to carefully monitor Shanekas pregnancy. […] From the moment families receive their fetal diagnosis, the psychosocial team members provide compassionate, individualized care for the entire family. […] The team of specialists had been preparing for that day since Amari and Javar were born. […] Amari and Javar are working with occupational, physical, music and play therapists, plus a speech therapist who helps with feeding. […] Shaneka and Tim are getting comfortable with caring for the boys as they continue to heal and learn to do things like flip over, lie on their stomachs, and crawl.

• #2 Conjoined Twins – Seattle Children’s

  https://www.seattlechildrens.org/conditions/conjoined-twins/

  Whether to do surgery to separate your twins depends on their chance of survival and quality of life for each baby. […] Sometimes separation surgery is not possible for a variety of reasons, so staying connected is the only real option. Some conjoined twins have happy, healthy, full lives by staying connected. […] Your healthcare team will speak with you about what your twins lives may be like whether they are joined or separated. They will help you consider which option is best for your twins. […] Whether they stay connected or are separated, your twins will need long-term follow-up visits during childhood and into their early adult years. The healthcare team will check your childrens growth and development. We care for any long-term medical issues they might have. […] Seattle Childrens is one of the nations most experienced hospitals in treating conjoined twins. Care starts during pregnancy, as we monitor your twins health, learn as much as we can about their condition and plan for their care after birth. We help you understand all your options so you can make the choices that are best for your family.

• #2 Tyler family overcomes challenges to care for conjoined twin girls

  https://www.kltv.com/2023/02/03/tyler-family-overcomes-challenges-care-conjoined-twin-girls/

  A family in Texas is learning to navigate life with conjoined twin girls, who are now 5 months old. […] Their twin girls, born last August, were conjoined, sharing a heart and liver with only a slim chance of surviving. […] Driving the babies to appointments is just one of many challenges faced by the family since no car seat exists to meet their unique need. […] They are under the hospice care of Dr. Amy Starr, a pediatrician with CHRISTUS Trinity Clinic. […] Dr. Starr and nurses have to travel to the home. […] The family is seeking help from anyone who knows how to design, build or adapt a car seat for their children.

• #2 Conjoined Twins: Definition, Causes & Outlook

  https://my.clevelandclinic.org/health/diseases/22895-conjoined-twins

  Conjoined twins are rare. Complications can be reduced with close management from healthcare professionals. […] Delivery by C-section is the most common way to manage this situation. […] Successful management usually involves several medical and surgical specialists. […] The decision to attempt separation or not can bring up difficult ethical questions. […] In some cases, it’s possible to separate conjoined twins. […] The procedure to separate twins always takes extensive planning by a team of highly experienced surgeons. […] Many healthcare providers feel that surgical separation should take place when conjoined twins are 9 to 12 months old. […] Healthcare providers can manage complications to improve the outlook for conjoined twins. […] Some conjoined twins who can’t be separated can still enjoy a good quality of life if they’re closely monitored.

• #2 3D technology helps separate conjoined twins | College | College of Science and Engineering

  https://cse.umn.edu/college/news/3d-technology-helps-separate-conjoined-twins

  We anticipated every little problem we were going to have, Saltzman said. […] On May 25, 2017, at 6:30 a.m., all the preparation and planning was put to the test. Nine hours later, Paislyn and Paisleigh were successfully separated and on the road to recovery. […] The 3D modeling and some of the other imaging really helped us prepare for that, Azakie added. […] Performing a conjoined twins separation surgery is rare. The innovative thinking, collaboration and cooperation it required could be applied to many future medical cases, and that wisdom will be passed on to health sciences students, Minnesotas future health care leaders.

• #2 Doctors talk about ethical decisions, surgery on conjoined twins | Association of Health Care Journalists

  https://healthjournalism.org/blog/2017/12/doctors-talk-about-ethical-decisions-surgery-on-conjoined-twins/

  The twin girls were joined at the abdomen and pelvis. They had two heads and four arms, but three legs. They had two hearts, but shared a liver, a bladder, and other organs. […] The team determined that separation was feasible, but that only one of the twins would survive. That raised a host of ethical and moral questions, said Dr. Brian M. Cummings, chair of the hospitals Pediatric Ethics Committee. Among the issues they debated: Were the conjoined twins one person or two? Can doctors ever, morally or ethically, sacrifice one for the other? And who should decide the doctors or the parents? […] Some of the medical staff objected to intervening, saying they cant do harm and must let nature take its course, Cummings said. […] In the end, just three doctors chose not to participate in the surgery because of their discomfort.

• #2 Conjoined Twins | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/conjoined-twins

  A comprehensive post-delivery assessment will determine the long-term plan for a potential separation surgery. […] If the conjoined twins are candidates for separation surgery, CHOPs pediatric surgical team will work with a multidisciplinary team to monitor the babies and determine the timeline and approach for the surgical procedure. […] When the conjoined twins share a heart, successful surgical division is usually not possible. […] Since 1995, 133 pairs of conjoined twins have been referred to the Center for Fetal Diagnosis and Treatment, and 72 pairs have undergone prenatal evaluation. […] Childrens Hospital of Philadelphia has successfully separated 32 pairs of conjoined twins, the first in 1957.

• #2 Conjoined Twins – Greater Accra Regional Hospital

  https://garh.gov.gh/conjoined-twins/

  A comprehensive post-delivery assessment will determine the long-term plan for a potential separation surgery. While some life-threatening conditions may require immediate emergency surgery, a full assessment of shared structures should be performed before separation is attempted. Comprehensive evaluation of the cardiovascular system is particularly important in determining if separation is an option. […] One of the many procedures required to prepare twins for separation is the insertion of tissue expanders to increase the skin surface available to cover exposed tissue after surgery. […] As separated twins recover after surgery, they are closely followed by nutritionists, developmental pediatricians and other specialists to ensure their ability to thrive and grow.

• #2 Rare set of conjoined twins successfully separated in 24-hour surgery at UC Davis Children’s Hospital

  https://health.ucdavis.edu/news/headlines/rare-set-of-conjoined-twins-successfully-separated-in-24-hour-surgery-at-uc-davis-childrens-hospital/2020/10

  Nine-month-old conjoined twins Abigail and Micaela Bachinskiy are recovering at UC Davis Childrens Hospital after surgeons successfully separated them in a marathon surgery on Oct. 24 and 25. […] This was the first separation of conjoined twins at UC Davis Childrens Hospital. The team of experts included more than 30 people: surgeons, nurses, anesthesiologists and other key surgical staff. […] This is a landmark surgery for us at UC Davis Childrens Hospital, said Edwards, who has had previous success separating conjoined twins. […] UC Davis Health has provided care for Abigail and Micaela from the start even before birth. […] To prepare for the procedure, the surgical team spent months carefully tracking the twins growth through MRIs and CT scans. […] The surgical team and family kept in close touch in the months leading up to the procedure.

• #3

  https://journals.lww.com/pccmjournal/FullText/2014/05001/ABSTRACT_153__NURSING_CARE_IN_THORACO_OMPHALOPAGUS.150.aspx

  Conjoined twins are more common among girls. Conjunction usually occurs in thoracic region. Treatment possibility in thoraco-abdominal conjoined twins depends on the anatomy of cardiovascular system. Surgical intervention involves sacrificing one of the twins in order to save the other. […] The aim of this study is to share the nursing experience on thoraco-omphalopagus conjoined twins, which have difficulties regarding nursing care. […] Therefore their care should be given by trained and experienced nurses, and feelings and thoughts of the family should be shared.

• #3 Families celebrate GOSH’s Conjoined Twins Day | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/news/families-celebrate-goshs-conjoined-twins-day/

  Six sets of twins came together to be seen by their different teams on Great Ormond Street Hospitals Conjoined Twins Day. […] The Specialist Neonatal and Paediatric Surgery (SNAPS) team arranged the day so that the twins and their families had chance to meet each other, and in some cases be reunited. […] Since then, over 38 sets of conjoined twins have been cared for at GOSH separating more twins than anywhere in the world. […] The teams also include dedicated paediatricians, ward nurses and allied health professionals including physiotherapists, occupational therapists, dietitians, speech and language therapists, and the Play team, who all perform a vital part in the care and rehabilitation following the operations. […] Its impossible to list all those involved in their care, but were lucky that GOSH is one of the few places in the world that has so many skilled teams under one roof to separate conjoined twins and give them the best possible treatment.

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