Materiały źródłowe

• #1 Conjoined twins | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/conjoined-twins?lang=us

  Conjoined twin pregnancy is a rare occurrence resulting from the failure of a zygote to separate completely after 13 days. […] The prevalence of conjoined twins ranges from 1:50,000 to 1:200,000. […] Conjoined twins are monozygotic, monoamniotic, and monochorionic (MCMA) and result due to a failure of normal complete separation of the embryonic plate from an incomplete delayed division of the inner cell mass. […] Thus identification of a dividing membrane or two placentas excludes the diagnosis. […] The prognosis for conjoined twins, in general, is quite poor. Approximately 40-60% of conjoined twins are stillborn and almost 35% of live births do not survive beyond 24 hours. Of those who do survive, surgical separation is sometimes possible.

• #2 Prenatal diagnosis of non-janiceps type of cephalopagus conjoined twins: a case report | Egyptian Journal of Radiology and Nuclear Medicine | Full Text

  https://ejrnm.springeropen.com/articles/10.1186/s43055-023-01008-x

  Conjoined twin pregnancy is a very rare variety of twin pregnancy which results from the failure of complete separation of a zygote after 13 days, cephalopagus being the rarest variety of such twin pregnancies. […] The features that may hint towards the diagnosis on ultrasound include inseparable fetal bodies, unvarying relative positioning of the two fetuses, both heads persistently at the same level to each other, bi-breech or bicephalic presentations and a single umbilical cord with more than three vessels. 3-D ultrasound and Fetal MRI may help in confirmation of this rare entity. […] A very rare case of non-Janiceps variety of cephalopagus conjoined twin gestation which was detected at 12 weeks of gestation by antenatal ultrasound and confirmed on fetal MRI. Early antenatal diagnosis is extremely important for appropriate and timely management as the prognosis is very poor in such twins. Antenatal ultrasound and fetal MRI prove very beneficial in this aspect as well as for diagnosis of other associated fetal abnormalities.

• #3 Conjoined twins – role of imaging and recent advances

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5769666/

  Conjoined twins are identical twins with fused bodies, joined in utero. They are rare complications of monochorionic twinning. The purpose of this study is to describe the various types of conjoined twins, the role of imaging and recent advances aiding in their management. […] All the 3 cases were identified antenatally by ultrasound. Only one case was further evaluated by MRI. […] Three cases of conjoined twins (cephalopagus, thoracopagus and omphalopagus) were accurately diagnosed on antenatal ultrasound. […] Ultrasound enables an early and accurate diagnosis of conjoined twins, which is vital for obstetric management. MRI is reserved for better tissue characterization. […] Recent advances, such as 3D printing, may aid in surgical pre-planning, thereby enabling successful surgical separation of conjoined twins.

• #4 Diagnosis and Management of Conjoined Twins | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-030-47652-6_19

  Conjoined twins (CT) are a rare complication of monoamniotic twinning. […] Ultrasound, 3D ultrasound, and magnetic resonance imaging are critical for antenatal diagnosis, careful analysis of the area of fusion, and subsequent prognostication. […] Only a minority of twins that survive birth will go on to be candidates for surgical separation. […] Surgical separation should only be attempted at centers with expertise in these procedures, which are complex and frequently associated with residual morbidity. […] Because the ethical considerations of surgical separation are complex, a palliative care team is critical for understanding patient and her family’s goals and preferences.

• #5 Conjoined twins | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/conjoined-twins?lang=us

  Conjoined twin pregnancy is a rare occurrence resulting from the failure of a zygote to separate completely after 13 days. […] The prevalence of conjoined twins ranges from 1:50,000 to 1:200,000. […] Conjoined twins are monozygotic, monoamniotic, and monochorionic (MCMA) and result due to a failure of normal complete separation of the embryonic plate from an incomplete delayed division of the inner cell mass. […] Thus identification of a dividing membrane or two placentas excludes the diagnosis. […] The prognosis for conjoined twins, in general, is quite poor. Approximately 40-60% of conjoined twins are stillborn and almost 35% of live births do not survive beyond 24 hours. Of those who do survive, surgical separation is sometimes possible.

• #6 Conjoined twins | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/conjoined-twins?lang=us

  Conjoined twin pregnancy is a rare occurrence resulting from the failure of a zygote to separate completely after 13 days. […] The prevalence of conjoined twins ranges from 1:50,000 to 1:200,000. […] Conjoined twins are monozygotic, monoamniotic, and monochorionic (MCMA) and result due to a failure of normal complete separation of the embryonic plate from an incomplete delayed division of the inner cell mass. […] Thus identification of a dividing membrane or two placentas excludes the diagnosis. […] The prognosis for conjoined twins, in general, is quite poor. Approximately 40-60% of conjoined twins are stillborn and almost 35% of live births do not survive beyond 24 hours. Of those who do survive, surgical separation is sometimes possible.

• #7 Conjoined twins in dichorionic diamniotic triplet pregnancy: a report of three cases and literature review | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-021-04165-x

  Prenatal screening and diagnosis of conjoined twins is usually performed by ultrasonography. MRI can be used to assist in the diagnosis if necessary. […] Conjoined twins have a low survival rate, and the prognosis is generally poor. Twenty-five percent of live births live to the age of surgery. Only 60% of surgical separation cases survive; therefore, early antenatal diagnosis is important. […] Early antenatal diagnosis of conjoined twins and determination of chorionicity of triplet gestations are critical for individualized management options and the prognosis of the normal fetus. Expecting parents should be extensively counseled by a multidisciplinary team. Early selective termination of the conjoined twins by intrathoracic injection of potassium chloride may be a procedure in dichorionic diamniotic triplet pregnancies to improve the perinatal outcomes of the normal fetus in triplets.

• #8 Conjoined twins in dichorionic diamniotic triplet pregnancy: a report of three cases and literature review | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-021-04165-x

  Prenatal screening and diagnosis of conjoined twins is usually performed by ultrasonography. MRI can be used to assist in the diagnosis if necessary. […] Conjoined twins have a low survival rate, and the prognosis is generally poor. Twenty-five percent of live births live to the age of surgery. Only 60% of surgical separation cases survive; therefore, early antenatal diagnosis is important. […] Early antenatal diagnosis of conjoined twins and determination of chorionicity of triplet gestations are critical for individualized management options and the prognosis of the normal fetus. Expecting parents should be extensively counseled by a multidisciplinary team. Early selective termination of the conjoined twins by intrathoracic injection of potassium chloride may be a procedure in dichorionic diamniotic triplet pregnancies to improve the perinatal outcomes of the normal fetus in triplets.

• #9 The Fetal Medicine Foundation

  https://fetalmedicine.org/education/fetal-abnormalities/multiple-pregnancies/mc-twins-conjoined-twins

  MC twins: conjoined twins […] Prevalence: […] 1% of monochorionic twins. […] Results from incomplete splitting of the embryonic mass after day 12 of fertilization. […] Ultrasound diagnosis: […] Fused twins in monochorionic monoamniotic pregnancy. […] Classified according to the site of fusion followed by pagus (Greek word for 'what is fixed’). Most common type is thoracopagus (75% of cases) with fusion in the thorax and abdomen and often conjoined hearts, livers and intestines. […] Other types include pygopagus (fetuses fused at the rump), ischiopagus (fetuses fused at the lower half of the bodies with spines conjoined end to end at 180o angle), craniophagus (fused skulls and separate bodies), omphalopagus (fused at the lower abdomen, with shared liver and intestines). […] Investigations:

• #10 The Fetal Medicine Foundation

  https://fetalmedicine.org/education/fetal-abnormalities/multiple-pregnancies/mc-twins-conjoined-twins

  MC twins: conjoined twins […] Prevalence: […] 1% of monochorionic twins. […] Results from incomplete splitting of the embryonic mass after day 12 of fertilization. […] Ultrasound diagnosis: […] Fused twins in monochorionic monoamniotic pregnancy. […] Classified according to the site of fusion followed by pagus (Greek word for 'what is fixed’). Most common type is thoracopagus (75% of cases) with fusion in the thorax and abdomen and often conjoined hearts, livers and intestines. […] Other types include pygopagus (fetuses fused at the rump), ischiopagus (fetuses fused at the lower half of the bodies with spines conjoined end to end at 180o angle), craniophagus (fused skulls and separate bodies), omphalopagus (fused at the lower abdomen, with shared liver and intestines). […] Investigations:

• #11 The Fetal Medicine Foundation

  https://fetalmedicine.org/education/fetal-abnormalities/multiple-pregnancies/mc-twins-conjoined-twins

  MC twins: conjoined twins […] Prevalence: […] 1% of monochorionic twins. […] Results from incomplete splitting of the embryonic mass after day 12 of fertilization. […] Ultrasound diagnosis: […] Fused twins in monochorionic monoamniotic pregnancy. […] Classified according to the site of fusion followed by pagus (Greek word for 'what is fixed’). Most common type is thoracopagus (75% of cases) with fusion in the thorax and abdomen and often conjoined hearts, livers and intestines. […] Other types include pygopagus (fetuses fused at the rump), ischiopagus (fetuses fused at the lower half of the bodies with spines conjoined end to end at 180o angle), craniophagus (fused skulls and separate bodies), omphalopagus (fused at the lower abdomen, with shared liver and intestines). […] Investigations:

• #12 The Fetal Medicine Foundation

  https://fetalmedicine.org/education/fetal-abnormalities/multiple-pregnancies/mc-twins-conjoined-twins

  MC twins: conjoined twins […] Prevalence: […] 1% of monochorionic twins. […] Results from incomplete splitting of the embryonic mass after day 12 of fertilization. […] Ultrasound diagnosis: […] Fused twins in monochorionic monoamniotic pregnancy. […] Classified according to the site of fusion followed by pagus (Greek word for 'what is fixed’). Most common type is thoracopagus (75% of cases) with fusion in the thorax and abdomen and often conjoined hearts, livers and intestines. […] Other types include pygopagus (fetuses fused at the rump), ischiopagus (fetuses fused at the lower half of the bodies with spines conjoined end to end at 180o angle), craniophagus (fused skulls and separate bodies), omphalopagus (fused at the lower abdomen, with shared liver and intestines). […] Investigations:

• #13 The Fetal Medicine Foundation

  https://fetalmedicine.org/education/fetal-abnormalities/multiple-pregnancies/mc-twins-conjoined-twins

  MC twins: conjoined twins […] Prevalence: […] 1% of monochorionic twins. […] Results from incomplete splitting of the embryonic mass after day 12 of fertilization. […] Ultrasound diagnosis: […] Fused twins in monochorionic monoamniotic pregnancy. […] Classified according to the site of fusion followed by pagus (Greek word for 'what is fixed’). Most common type is thoracopagus (75% of cases) with fusion in the thorax and abdomen and often conjoined hearts, livers and intestines. […] Other types include pygopagus (fetuses fused at the rump), ischiopagus (fetuses fused at the lower half of the bodies with spines conjoined end to end at 180o angle), craniophagus (fused skulls and separate bodies), omphalopagus (fused at the lower abdomen, with shared liver and intestines). […] Investigations:

• #14 The Fetal Medicine Foundation

  https://fetalmedicine.org/education/fetal-abnormalities/multiple-pregnancies/mc-twins-conjoined-twins

  MC twins: conjoined twins […] Prevalence: […] 1% of monochorionic twins. […] Results from incomplete splitting of the embryonic mass after day 12 of fertilization. […] Ultrasound diagnosis: […] Fused twins in monochorionic monoamniotic pregnancy. […] Classified according to the site of fusion followed by pagus (Greek word for 'what is fixed’). Most common type is thoracopagus (75% of cases) with fusion in the thorax and abdomen and often conjoined hearts, livers and intestines. […] Other types include pygopagus (fetuses fused at the rump), ischiopagus (fetuses fused at the lower half of the bodies with spines conjoined end to end at 180o angle), craniophagus (fused skulls and separate bodies), omphalopagus (fused at the lower abdomen, with shared liver and intestines). […] Investigations:

• #15 The Fetal Medicine Foundation

  https://fetalmedicine.org/education/fetal-abnormalities/multiple-pregnancies/mc-twins-conjoined-twins

  MC twins: conjoined twins […] Prevalence: […] 1% of monochorionic twins. […] Results from incomplete splitting of the embryonic mass after day 12 of fertilization. […] Ultrasound diagnosis: […] Fused twins in monochorionic monoamniotic pregnancy. […] Classified according to the site of fusion followed by pagus (Greek word for 'what is fixed’). Most common type is thoracopagus (75% of cases) with fusion in the thorax and abdomen and often conjoined hearts, livers and intestines. […] Other types include pygopagus (fetuses fused at the rump), ischiopagus (fetuses fused at the lower half of the bodies with spines conjoined end to end at 180o angle), craniophagus (fused skulls and separate bodies), omphalopagus (fused at the lower abdomen, with shared liver and intestines). […] Investigations:

• #16

  https://link.springer.com/article/10.1007/s40556-015-0039-x

  Cephalopagus is the rarest type of conjoined twins. Early antenatal diagnosis is important in view of extremely poor prognosis as surgical separation is not possible in such cases. […] Early and accurate prenatal diagnosis of cephalopagus twins enables parents to opt for early pregnancy termination, thus reducing the risk of trauma to the birth canal via vaginal delivery in such cases. Ultrasonography and magnetic resonance imaging (MRI) are excellent noninvasive techniques that aid in the diagnosis and management of such cases. […] Therefore, early prenatal diagnosis of cephalopagus by ultrasonography and MRI is extremely important. Timely obstetric management helps in minimizing maternal and fetal morbidity and mortality. […] Antenatal ultrasound is capable of diagnosing a conjoined twin pregnancy as early as 12 weeks gestation.

• #17 Conjoined Twins – Fetal Health Foundation

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

  Conjoined twins are categorized by where they are connected. Approximately 75% are joined at the chest wall or upper abdomen, 23% are connected at the hips, legs, or genitalia, and only 2% are joined at the head. […] Typically, a diagnosis of conjoined twins occurs early in pregnancy by using prenatal ultrasound. Further evaluations are later conducted, usually after 18 weeks, using ultrasound, MRI, and echocardiogram technology to understand the location and extent of the connection and help determine whether separation surgery after birth is possible. […] 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.

• #18 Antenatal diagnosis of thoracopagus and thoraco-omphalopagus conjoined twins: case series | Egyptian Journal of Radiology and Nuclear Medicine | Full Text

  https://ejrnm.springeropen.com/articles/10.1186/s43055-023-01152-4

  Conjoined twin pregnancy is a rare variety, which occurs due to incomplete separation of the embryonic plate after 13 days. […] So a comprehensive multidisciplinary prenatal assessment of conjoined twins is crucial for providing accurate parental counseling, effectively managing the pregnancy, and formulating an appropriate delivery strategy. […] The purpose of our study was to early diagnosis of conjoined twins using ultrasound, describing the various types of conjoined twins and the role of recent advances like 3D ultrasound in aiding their management. […] Four cases of conjoined twins (two thoracopagus and two thoraco-omphalopagus) were accurately diagnosed on antenatal ultrasound. […] Ultrasound plays a vital role in the early diagnosis and management of conjoined twins. […] Timely antenatal screening, including ultrasound and fetal MRI, plays an important role in the early detection of conjoined and in counseling parents about potential surgical or medical termination options and outcomes.

• #19 Early ultrasound diagnosis of conjoined twins at eight weeks of pregnancy: A case report

  https://www.wjgnet.com/2307-8960/full/v8/i21/5389.htm

  Herein we report a case of conjoined twins suspected of cardiac fusion diagnosed by prenatal ultrasound at 8 wk gestation and confirmed by surgery. […] Early diagnosis of conjoined twins has the following advantages. First, through the early evaluation of the degree of fusion, the optimal treatment time and strategy can be selected. […] Early evaluation will also help parents to choose early termination, thereby reducing the risk of trauma during vaginal delivery. […] This study suggests that active and regular antenatal ultrasonic examinations provide a great opportunity for good prognosis. […] We suppose that an ultrasound examination at 7-8 wk of pregnancy plays an important role in the early diagnosis of congenital malformations in twins.

• #20 Conjoined twins – role of imaging and recent advances

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5769666/

  Imaging plays a crucial role in the antenatal and postnatal life of conjoined twins, with the initial modality for screening being ultrasound followed by other modalities such as computed tomography (CT) and/or magnetic resonance imaging (MRI). […] An antenatal diagnosis of conjoined twins can be made on ultrasound in the 1st trimester. […] Successful separation of conjoined twins requires the joint effort of a team comprising various specialists, including radiologists, obstetricians and pediatric subspecialized surgeons. […] The surgical team requires to be aware of the latest developments and available tools, such as 3D printing which will not only help them in pre-surgical planning but may also help to reduce morbidity and complications.

• #21 Ultrasound diagnosis of cephalopagus conjoined twin pregnancy at 29 weeks – ScienceOpen

  https://www.scienceopen.com/document/read?vid=0e475834-cbe5-46ac-80ff-5af5c6c3f19b

  The authors report a case of a cephalopagus conjoined twin that was diagnosed at 29 weeks of gestation despite the mother having had two ultrasounds done previously. […] Antenatal ultrasound images are supplemented by post natal photographs. A review of literature, clues to ultrasound diagnosis and possible causes of missing this significant abnormality until the 3rd trimester are discussed. […] Conjoined twins are rare and are reported to occur with a prevalence of 1:50,000 in utero to 1:250,000 live births. […] Before the widespread use of ultrasound, most conjoined twins could not be identified in utero. […] The authors’ case was diagnosed at 29 weeks of gestation after the mother had undergone two ultrasounds at 22 weeks and at 28 weeks during which no abnormality was reported.

• #22 Conjoined twins – role of imaging and recent advances

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5769666/

  Imaging plays a crucial role in the antenatal and postnatal life of conjoined twins, with the initial modality for screening being ultrasound followed by other modalities such as computed tomography (CT) and/or magnetic resonance imaging (MRI). […] An antenatal diagnosis of conjoined twins can be made on ultrasound in the 1st trimester. […] Successful separation of conjoined twins requires the joint effort of a team comprising various specialists, including radiologists, obstetricians and pediatric subspecialized surgeons. […] The surgical team requires to be aware of the latest developments and available tools, such as 3D printing which will not only help them in pre-surgical planning but may also help to reduce morbidity and complications.

• #23 Early ultrasound diagnosis of conjoined twins at eight weeks of pregnancy: A case report

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7674739/

  Conjoined twins are a rare occurrence, and the majority of these malformations are detected during second trimester screening. […] Herein we report a case of conjoined twins, which was diagnosed by ultrasound at 8 wk gestation and was normal at 7 wk gestation. The two fetuses shared one heart and were diagnosed as thoracopagus twins. This is the first report of conjoined twins diagnosed at 8 wk gestation. […] Because some congenital malformations can be diagnosed earlier, a prenatal ultrasound examination at an early gestational stage cannot be dismissed. […] This case demonstrates that a 7-8 wk gestation might be the earliest period when conjoined twins can be diagnosed by ultrasound. […] We found that ultrasound examination at 7-8 wk of pregnancy plays an important role in the early diagnosis of congenital malformation in twins.

• #24 Early ultrasound diagnosis of conjoined twins at eight weeks of pregnancy: A case report

  https://www.wjgnet.com/2307-8960/full/v8/i21/5389.htm

  Early ultrasound diagnosis of conjoined twins at eight weeks of pregnancy: A case report. […] Herein we report a case of conjoined twins, which was diagnosed by ultrasound at 8 wk gestation and was normal at 7 wk gestation. […] This is the first report of conjoined twins diagnosed at 8 wk gestation. […] Because some congenital malformations can be diagnosed earlier, a prenatal ultrasound examination at an early gestational stage cannot be dismissed. […] This case demonstrates that a 7-8 wk gestation might be the earliest period when conjoined twins can be diagnosed by ultrasound. […] A woman at 8 wk of pregnancy with low progesterone levels came to the hospital for a routine ultrasound examination. […] We found that ultrasound examination at 7-8 wk of pregnancy plays an important role in the early diagnosis of congenital malformation in twins.

• #25 Early ultrasound diagnosis of conjoined twins at eight weeks of pregnancy: A case report

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7674739/

  Conjoined twins are a rare occurrence, and the majority of these malformations are detected during second trimester screening. […] Herein we report a case of conjoined twins, which was diagnosed by ultrasound at 8 wk gestation and was normal at 7 wk gestation. The two fetuses shared one heart and were diagnosed as thoracopagus twins. This is the first report of conjoined twins diagnosed at 8 wk gestation. […] Because some congenital malformations can be diagnosed earlier, a prenatal ultrasound examination at an early gestational stage cannot be dismissed. […] This case demonstrates that a 7-8 wk gestation might be the earliest period when conjoined twins can be diagnosed by ultrasound. […] We found that ultrasound examination at 7-8 wk of pregnancy plays an important role in the early diagnosis of congenital malformation in twins.

• #26 Early ultrasound diagnosis of conjoined twins at eight weeks of pregnancy: A case report

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7674739/

  Conjoined twins are a rare occurrence, and the majority of these malformations are detected during second trimester screening. […] Herein we report a case of conjoined twins, which was diagnosed by ultrasound at 8 wk gestation and was normal at 7 wk gestation. The two fetuses shared one heart and were diagnosed as thoracopagus twins. This is the first report of conjoined twins diagnosed at 8 wk gestation. […] Because some congenital malformations can be diagnosed earlier, a prenatal ultrasound examination at an early gestational stage cannot be dismissed. […] This case demonstrates that a 7-8 wk gestation might be the earliest period when conjoined twins can be diagnosed by ultrasound. […] We found that ultrasound examination at 7-8 wk of pregnancy plays an important role in the early diagnosis of congenital malformation in twins.

• #27 Antenatal diagnosis of thoracopagus and thoraco-omphalopagus conjoined twins: case series | Egyptian Journal of Radiology and Nuclear Medicine | Full Text

  https://ejrnm.springeropen.com/articles/10.1186/s43055-023-01152-4

  The early detection of conjoined twins has been significantly improved by the integration of first-trimester transvaginal ultrasonography, complemented by color Doppler and 3D ultrasound techniques, and has proven prognostic value. […] However, accurate prenatal diagnosis of conjoined twins can be performed with USG as early as 10-11 weeks gestation. […] The antenatal diagnosis of conjoined twins can be made with high-resolution ultrasound as early as 12 weeks gestation and is important for optimal obstetric management because early termination of pregnancy has less risk of complications.

• #28 Prenatal diagnosis of non-janiceps type of cephalopagus conjoined twins: a case report | Egyptian Journal of Radiology and Nuclear Medicine | Full Text

  https://ejrnm.springeropen.com/articles/10.1186/s43055-023-01008-x

  High level of suspicion is required to diagnose such cases on an ultrasound. One can diagnose a conjoined twin pregnancy as early as at 12 weeks of gestation. […] 3-D ultrasound can help in determining the extent of fusion of conjoined twins and thus help in proper classification, which would further help in appropriate management. […] Fetal MRI can help as a complimentary mode of investigation to the ultrasound as it can give reproducible fetal anatomy with better and detailed delineation of the associated congenital fetal abnormalities. […] Now with the advent of 3-D ultrasound techniques and faster MRI sequences, early prenatal diagnosis and appropriate classification of conjoined twins has become easier for optimal and timely obstetric as well as post natal management.

• #29 Difficulties in Antenatal Diagnosis of Conjoined Twins in an African Setting, 2 Cases Reports

  https://www.scivisionpub.com/articles/difficulties-in-antenatal-diagnosis-of-conjoined-twins-in-an-african-setting-2-cases-reports-1181.html

  Fetal imaging techniques have undergone considerable change over the past 30 years. […] The presence of conjoined twins is a rare possibility during pregnancy. […] Currently, the diagnosis must be carried out in the 1st trimester. […] Unfortunately, the accessibility to ultrasound in our countries with low medical density, as well as the cost of this examination make this diagnosis late. […] The precise analysis of the union site and the common organs is improved by the trans vaginal route, or even by 3D and Doppler imaging. […] In the age of ultrasound, no diagnosis of conjoined twins should come as a surprise to childbirth, even in developing countries. […] The diagnosis of conjoined twins is possible in the first trimester by 3D ultrasound. […] The antenatal diagnosis of conjoined twins is based entirely on ultrasound.

• #30 📃 History, classification, and two cases of conjoined twins

  https://thefetus.net/content/history-classification-and-two-cases-of-conjoined-twins

  Conjoined twins occur in approximately 0.2:10,000 births. […] The authors report two cases: (1) discovery at 13 weeks gestational age of omphalopagus twins; and (2) birth of conjoined twins at 35 weeks gestation. […] Sonography has demonstrated conjoined twins at the end of the first trimester since 1995. […] In 1995, Maggio reported a diagnosis of conjoined twins (thoracopagus with a single heart) at 8 weeks, 5 days, confirmed at 13 weeks gestational age. […] Early sonography shows continuity between the fetuses and fails to show independent movement. […] Diagnosis of conjoined twins is possible as early as 8 weeks gestation, but accurate evaluation of common structures is not possible. […] The 12-week scan allows clinicians to assess viability, and, in the case of nonviability, to propose early medical interruption of pregnancy, preventing hysterotomy in the case of a delayed termination. […] Early discovery of viable conjoined twins permits assessment of the best route of delivery and a planning for serial sonography and fast MRI to plan separation surgery.

• #31 Prenatal diagnosis of non-janiceps type of cephalopagus conjoined twins: a case report | Egyptian Journal of Radiology and Nuclear Medicine | Full Text

  https://ejrnm.springeropen.com/articles/10.1186/s43055-023-01008-x

  Conjoined twin pregnancy is a very rare variety of twin pregnancy which results from the failure of complete separation of a zygote after 13 days, cephalopagus being the rarest variety of such twin pregnancies. […] The features that may hint towards the diagnosis on ultrasound include inseparable fetal bodies, unvarying relative positioning of the two fetuses, both heads persistently at the same level to each other, bi-breech or bicephalic presentations and a single umbilical cord with more than three vessels. 3-D ultrasound and Fetal MRI may help in confirmation of this rare entity. […] A very rare case of non-Janiceps variety of cephalopagus conjoined twin gestation which was detected at 12 weeks of gestation by antenatal ultrasound and confirmed on fetal MRI. Early antenatal diagnosis is extremely important for appropriate and timely management as the prognosis is very poor in such twins. Antenatal ultrasound and fetal MRI prove very beneficial in this aspect as well as for diagnosis of other associated fetal abnormalities.

• #32 Internet Scientific Publications

  http://ispub.com/IJGO/12/2/7486

  Diagnostic criteria proposed include: absent separating membrane, conjoined body parts, inseparable bodies or heads despite changes in fetal position, bifid appearance of the fetal pole in the first trimester, more than three vessels in the umbilical cord, complex structural anomalies, heads or bodies at the same level, hyperextended spine, unusual proximity of the extremities, persistence of the relative positions after movement or at the follow-up scan. […] Recent reports have also presented data on the contribution of 3D ultrasonography to the antenatal diagnosis of conjoined twins. […] Detailed evaluation of the degree of union and number of shared organs is required to predict the viability and prognosis of the fetuses. […] Magnetic resonance imaging and computed tomography both provide excellent anatomic and bone detail, demonstrating organ position, shared viscera, and limited vascular anatomy, but the consensus appears to be that optimal evaluation is obtained with a combination of ultrasound and magnetic resonance imaging. […] Where the prognosis is poor, early diagnosis enables proper counselling of the family and gives the parents the option of termination.

• #33 Conjoined twins – role of imaging and recent advances

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5769666/

  Imaging plays a crucial role in the antenatal and postnatal life of conjoined twins, with the initial modality for screening being ultrasound followed by other modalities such as computed tomography (CT) and/or magnetic resonance imaging (MRI). […] An antenatal diagnosis of conjoined twins can be made on ultrasound in the 1st trimester. […] Successful separation of conjoined twins requires the joint effort of a team comprising various specialists, including radiologists, obstetricians and pediatric subspecialized surgeons. […] The surgical team requires to be aware of the latest developments and available tools, such as 3D printing which will not only help them in pre-surgical planning but may also help to reduce morbidity and complications.

• #34 Prenatal diagnosis of non-janiceps type of cephalopagus conjoined twins: a case report | Egyptian Journal of Radiology and Nuclear Medicine | Full Text

  https://ejrnm.springeropen.com/articles/10.1186/s43055-023-01008-x

  High level of suspicion is required to diagnose such cases on an ultrasound. One can diagnose a conjoined twin pregnancy as early as at 12 weeks of gestation. […] 3-D ultrasound can help in determining the extent of fusion of conjoined twins and thus help in proper classification, which would further help in appropriate management. […] Fetal MRI can help as a complimentary mode of investigation to the ultrasound as it can give reproducible fetal anatomy with better and detailed delineation of the associated congenital fetal abnormalities. […] Now with the advent of 3-D ultrasound techniques and faster MRI sequences, early prenatal diagnosis and appropriate classification of conjoined twins has become easier for optimal and timely obstetric as well as post natal management.

• #35

  https://link.springer.com/article/10.1007/s40556-015-0039-x

  The role of 3D ultrasound imaging has been emphasized to demonstrate the extent of fusion in conjoined twins and thus improve the accuracy of classification of conjoined twins. […] In conclusion, both ultrasound and MRI are excellent complementary tools for early diagnosis, better evaluation, and classification of conjoined twins.

• #36 Difficulties in Antenatal Diagnosis of Conjoined Twins in an African Setting, 2 Cases Reports

  https://www.scivisionpub.com/articles/difficulties-in-antenatal-diagnosis-of-conjoined-twins-in-an-african-setting-2-cases-reports-1181.html

  The 3D ultrasound facilitates the exploration of adjoining sites as well as the malformation assessment. […] The diagnosis is sometimes late in our context of under medicalization. […] The improvement of the management of conjoined twins can only be done in the event of early prenatal diagnosis which makes it possible to specify the common anatomical structures, to search for an associated congenital anomaly, to organize childbirth in an appropriate structure and to schedule multidisciplinary neonatal care.

• #37 Difficulties in Antenatal Diagnosis of Conjoined Twins in an African Setting, 2 Cases Reports

  https://www.scivisionpub.com/articles/difficulties-in-antenatal-diagnosis-of-conjoined-twins-in-an-african-setting-2-cases-reports-1181.html

  Fetal imaging techniques have undergone considerable change over the past 30 years. […] The presence of conjoined twins is a rare possibility during pregnancy. […] Currently, the diagnosis must be carried out in the 1st trimester. […] Unfortunately, the accessibility to ultrasound in our countries with low medical density, as well as the cost of this examination make this diagnosis late. […] The precise analysis of the union site and the common organs is improved by the trans vaginal route, or even by 3D and Doppler imaging. […] In the age of ultrasound, no diagnosis of conjoined twins should come as a surprise to childbirth, even in developing countries. […] The diagnosis of conjoined twins is possible in the first trimester by 3D ultrasound. […] The antenatal diagnosis of conjoined twins is based entirely on ultrasound.

• #38 Early ultrasound diagnosis of conjoined twins at eight weeks of pregnancy: A case report

  https://www.wjgnet.com/2307-8960/full/v8/i21/WJCC-8-5389-g002.htm

  Early ultrasound diagnosis of conjoined twins at eight weeks of pregnancy: A case report. […] Ultrasound imaging of the embryo at eight weeks gestation. […] Two embryos and two spines can be seen in the long axial view; […] Two brains can be seen in the short axial view; […] Two gastric vacuoles and two bladders can be seen; […] Color Doppler flow imaging showed that the two embryos had only one beating heart.

• #39 Difficulties in Antenatal Diagnosis of Conjoined Twins in an African Setting, 2 Cases Reports

  https://www.scivisionpub.com/articles/difficulties-in-antenatal-diagnosis-of-conjoined-twins-in-an-african-setting-2-cases-reports-1181.html

  Fetal imaging techniques have undergone considerable change over the past 30 years. […] The presence of conjoined twins is a rare possibility during pregnancy. […] Currently, the diagnosis must be carried out in the 1st trimester. […] Unfortunately, the accessibility to ultrasound in our countries with low medical density, as well as the cost of this examination make this diagnosis late. […] The precise analysis of the union site and the common organs is improved by the trans vaginal route, or even by 3D and Doppler imaging. […] In the age of ultrasound, no diagnosis of conjoined twins should come as a surprise to childbirth, even in developing countries. […] The diagnosis of conjoined twins is possible in the first trimester by 3D ultrasound. […] The antenatal diagnosis of conjoined twins is based entirely on ultrasound.

• #40 Journal of Ultrasonography

  https://jultrason.pl/index.php/wydawnictwa/volume-17-no-71/conjoined-twins-role-of-imaging-and-recent-advances

  Conjoined twins are identical twins with fused bodies, joined in utero. They are rare complications of monochorionic twinning. The purpose of this study is to describe the various types of conjoined twins, the role of imaging and recent advances aiding in their management. […] All the 3 cases were identified antenatally by ultrasound. Only one case was further evaluated by MRI. […] Three cases of conjoined twins (cephalopagus, thoracopagus and omphalopagus) were accurately diagnosed on antenatal ultrasound. […] Ultrasound enables an early and accurate diagnosis of conjoined twins, which is vital for obstetric management. MRI is reserved for better tissue characterization. […] Recent advances, such as 3D printing, may aid in surgical pre-planning, thereby enabling successful surgical separation of conjoined twins.

• #41 Journal of Ultrasonography

  https://jultrason.pl/index.php/wydawnictwa/volume-17-no-71/conjoined-twins-role-of-imaging-and-recent-advances

  Conjoined twins are identical twins with fused bodies, joined in utero. They are rare complications of monochorionic twinning. The purpose of this study is to describe the various types of conjoined twins, the role of imaging and recent advances aiding in their management. […] All the 3 cases were identified antenatally by ultrasound. Only one case was further evaluated by MRI. […] Three cases of conjoined twins (cephalopagus, thoracopagus and omphalopagus) were accurately diagnosed on antenatal ultrasound. […] Ultrasound enables an early and accurate diagnosis of conjoined twins, which is vital for obstetric management. MRI is reserved for better tissue characterization. […] Recent advances, such as 3D printing, may aid in surgical pre-planning, thereby enabling successful surgical separation of conjoined twins.

• #42 Internet Scientific Publications

  http://ispub.com/IJGO/12/2/7486

  Diagnostic criteria proposed include: absent separating membrane, conjoined body parts, inseparable bodies or heads despite changes in fetal position, bifid appearance of the fetal pole in the first trimester, more than three vessels in the umbilical cord, complex structural anomalies, heads or bodies at the same level, hyperextended spine, unusual proximity of the extremities, persistence of the relative positions after movement or at the follow-up scan. […] Recent reports have also presented data on the contribution of 3D ultrasonography to the antenatal diagnosis of conjoined twins. […] Detailed evaluation of the degree of union and number of shared organs is required to predict the viability and prognosis of the fetuses. […] Magnetic resonance imaging and computed tomography both provide excellent anatomic and bone detail, demonstrating organ position, shared viscera, and limited vascular anatomy, but the consensus appears to be that optimal evaluation is obtained with a combination of ultrasound and magnetic resonance imaging. […] Where the prognosis is poor, early diagnosis enables proper counselling of the family and gives the parents the option of termination.

• #43 Prenatal diagnosis of non-janiceps type of cephalopagus conjoined twins: a case report | Egyptian Journal of Radiology and Nuclear Medicine | Full Text

  https://ejrnm.springeropen.com/articles/10.1186/s43055-023-01008-x

  Conjoined twin pregnancy is a very rare variety of twin pregnancy which results from the failure of complete separation of a zygote after 13 days, cephalopagus being the rarest variety of such twin pregnancies. […] The features that may hint towards the diagnosis on ultrasound include inseparable fetal bodies, unvarying relative positioning of the two fetuses, both heads persistently at the same level to each other, bi-breech or bicephalic presentations and a single umbilical cord with more than three vessels. 3-D ultrasound and Fetal MRI may help in confirmation of this rare entity. […] A very rare case of non-Janiceps variety of cephalopagus conjoined twin gestation which was detected at 12 weeks of gestation by antenatal ultrasound and confirmed on fetal MRI. Early antenatal diagnosis is extremely important for appropriate and timely management as the prognosis is very poor in such twins. Antenatal ultrasound and fetal MRI prove very beneficial in this aspect as well as for diagnosis of other associated fetal abnormalities.

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

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

  Conjoined twins are typically diagnosed early in pregnancy with prenatal ultrasound. The optimal evaluation period for additional prenatal testing is after 18 weeks gestation. […] 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. […] Prenatal diagnosis will help identify the optimal treatment and delivery plan, and the potential for separation after birth. […] The following imaging tests are used to diagnose and evaluate conjoined twins: Fetal ultrasound, Fetal echocardiogram, Ultrafast fetal MRI. […] Indicators of conjoined twins include lack of a separating membrane between the twins, inability to separate the fetal bodies, and constant position of the fetal heads.

• #45 Prenatal diagnosis of non-janiceps type of cephalopagus conjoined twins: a case report | Egyptian Journal of Radiology and Nuclear Medicine | Full Text

  https://ejrnm.springeropen.com/articles/10.1186/s43055-023-01008-x

  High level of suspicion is required to diagnose such cases on an ultrasound. One can diagnose a conjoined twin pregnancy as early as at 12 weeks of gestation. […] 3-D ultrasound can help in determining the extent of fusion of conjoined twins and thus help in proper classification, which would further help in appropriate management. […] Fetal MRI can help as a complimentary mode of investigation to the ultrasound as it can give reproducible fetal anatomy with better and detailed delineation of the associated congenital fetal abnormalities. […] Now with the advent of 3-D ultrasound techniques and faster MRI sequences, early prenatal diagnosis and appropriate classification of conjoined twins has become easier for optimal and timely obstetric as well as post natal management.

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

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

  Conjoined twins are typically diagnosed early in pregnancy with prenatal ultrasound. The optimal evaluation period for additional prenatal testing is after 18 weeks gestation. […] 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. […] Prenatal diagnosis will help identify the optimal treatment and delivery plan, and the potential for separation after birth. […] The following imaging tests are used to diagnose and evaluate conjoined twins: Fetal ultrasound, Fetal echocardiogram, Ultrafast fetal MRI. […] Indicators of conjoined twins include lack of a separating membrane between the twins, inability to separate the fetal bodies, and constant position of the fetal heads.

• #47 Conjoined Twins – Greater Accra Regional Hospital

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

  Conjoined twins are typically diagnosed early in pregnancy with prenatal ultrasound. The optimal evaluation period for additional prenatal testing is after 18 weeks’ gestation. […] 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 plays a crucial role in deciding whether the twins will be separable. […] 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. […] The following imaging tests are used to diagnose and evaluate conjoined twins: Fetal ultrasound: A safe, noninvasive procedure that uses high frequency sound waves to provide detailed high-resolution images, including 3-D and 4-D views. Fetal echocardiogram: A noninvasive ultrasound procedure that assesses the structure and function of the fetal heart. Fetal echocardiogram is the most important test for the evaluation of conjoined twins, as it determines if the twins share a heart and if so, where that connection occurs. Ultrafast fetal MRI: An imaging technique pioneered at the Children’s Hospital that can include 3-D MRI reconstruction.

• #48 Conjoined Twins – Greater Accra Regional Hospital

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

  Conjoined twins are typically diagnosed early in pregnancy with prenatal ultrasound. The optimal evaluation period for additional prenatal testing is after 18 weeks’ gestation. […] 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 plays a crucial role in deciding whether the twins will be separable. […] 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. […] The following imaging tests are used to diagnose and evaluate conjoined twins: Fetal ultrasound: A safe, noninvasive procedure that uses high frequency sound waves to provide detailed high-resolution images, including 3-D and 4-D views. Fetal echocardiogram: A noninvasive ultrasound procedure that assesses the structure and function of the fetal heart. Fetal echocardiogram is the most important test for the evaluation of conjoined twins, as it determines if the twins share a heart and if so, where that connection occurs. Ultrafast fetal MRI: An imaging technique pioneered at the Children’s Hospital that can include 3-D MRI reconstruction.

• #49 Conjoined Twins – Greater Accra Regional Hospital

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

  Conjoined twins are typically diagnosed early in pregnancy with prenatal ultrasound. The optimal evaluation period for additional prenatal testing is after 18 weeks’ gestation. […] 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 plays a crucial role in deciding whether the twins will be separable. […] 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. […] The following imaging tests are used to diagnose and evaluate conjoined twins: Fetal ultrasound: A safe, noninvasive procedure that uses high frequency sound waves to provide detailed high-resolution images, including 3-D and 4-D views. Fetal echocardiogram: A noninvasive ultrasound procedure that assesses the structure and function of the fetal heart. Fetal echocardiogram is the most important test for the evaluation of conjoined twins, as it determines if the twins share a heart and if so, where that connection occurs. Ultrafast fetal MRI: An imaging technique pioneered at the Children’s Hospital that can include 3-D MRI reconstruction.

• #50 Conjoined Twins – Greater Accra Regional Hospital

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

  Indicators of conjoined twins include the lack of a separating membrane between the twins, inability to separate the fetal bodies, and constant position of the fetal heads. […] 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. […] When the conjoined twins share a heart, successful surgical division is usually not possible.

• #51 Conjoined Twins – Greater Accra Regional Hospital

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

  Indicators of conjoined twins include the lack of a separating membrane between the twins, inability to separate the fetal bodies, and constant position of the fetal heads. […] 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. […] When the conjoined twins share a heart, successful surgical division is usually not possible.

• #52 Parasitic Twin: Causes, Diagnosis & Removal

  https://my.clevelandclinic.org/health/diseases/23513-parasitic-twin

  A parasitic twin is a type of conjoined twin where one fetus stops developing but remains attached to its twin. […] A parasitic twin is a rare condition that happens when a conjoined twin stops developing. […] A parasitic twin is also known as asymmetrical or unequal conjoined twins, vestigial twins, fetus in fetu, and heteropagus twins. […] A parasitic twin is a type of conjoined twin. It accounts for about 10% of all conjoined twins. […] A parasitic twin is very rare. It affects less than 1 in 1 million births worldwide. […] Your healthcare provider may diagnose parasitic twins in a prenatal ultrasound. […] If a parasitic twin is suspected, an echocardiogram may be necessary to determine if the parasitic twin is putting strain on the autositic (dominant) twins heart. […] Surgical removal of the parasitic twin from the dominant twin is necessary.

• #53 Internet Scientific Publications

  http://ispub.com/IJGO/12/2/7486

  Diagnostic criteria proposed include: absent separating membrane, conjoined body parts, inseparable bodies or heads despite changes in fetal position, bifid appearance of the fetal pole in the first trimester, more than three vessels in the umbilical cord, complex structural anomalies, heads or bodies at the same level, hyperextended spine, unusual proximity of the extremities, persistence of the relative positions after movement or at the follow-up scan. […] Recent reports have also presented data on the contribution of 3D ultrasonography to the antenatal diagnosis of conjoined twins. […] Detailed evaluation of the degree of union and number of shared organs is required to predict the viability and prognosis of the fetuses. […] Magnetic resonance imaging and computed tomography both provide excellent anatomic and bone detail, demonstrating organ position, shared viscera, and limited vascular anatomy, but the consensus appears to be that optimal evaluation is obtained with a combination of ultrasound and magnetic resonance imaging. […] Where the prognosis is poor, early diagnosis enables proper counselling of the family and gives the parents the option of termination.

• #54 Internet Scientific Publications

  http://ispub.com/IJGO/12/2/7486

  Diagnostic criteria proposed include: absent separating membrane, conjoined body parts, inseparable bodies or heads despite changes in fetal position, bifid appearance of the fetal pole in the first trimester, more than three vessels in the umbilical cord, complex structural anomalies, heads or bodies at the same level, hyperextended spine, unusual proximity of the extremities, persistence of the relative positions after movement or at the follow-up scan. […] Recent reports have also presented data on the contribution of 3D ultrasonography to the antenatal diagnosis of conjoined twins. […] Detailed evaluation of the degree of union and number of shared organs is required to predict the viability and prognosis of the fetuses. […] Magnetic resonance imaging and computed tomography both provide excellent anatomic and bone detail, demonstrating organ position, shared viscera, and limited vascular anatomy, but the consensus appears to be that optimal evaluation is obtained with a combination of ultrasound and magnetic resonance imaging. […] Where the prognosis is poor, early diagnosis enables proper counselling of the family and gives the parents the option of termination.

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

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

  Conjoined twins are typically diagnosed early in pregnancy with prenatal ultrasound. The optimal evaluation period for additional prenatal testing is after 18 weeks gestation. […] 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. […] Prenatal diagnosis will help identify the optimal treatment and delivery plan, and the potential for separation after birth. […] The following imaging tests are used to diagnose and evaluate conjoined twins: Fetal ultrasound, Fetal echocardiogram, Ultrafast fetal MRI. […] Indicators of conjoined twins include lack of a separating membrane between the twins, inability to separate the fetal bodies, and constant position of the fetal heads.

• #56 Early ultrasound diagnosis of conjoined twins at eight weeks of pregnancy: A case report

  https://www.wjgnet.com/2307-8960/full/v8/i21/WJCC-8-5389-g002.htm

  Early ultrasound diagnosis of conjoined twins at eight weeks of pregnancy: A case report. […] Ultrasound imaging of the embryo at eight weeks gestation. […] Two embryos and two spines can be seen in the long axial view; […] Two brains can be seen in the short axial view; […] Two gastric vacuoles and two bladders can be seen; […] Color Doppler flow imaging showed that the two embryos had only one beating heart.

• #57 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. […] While some life-threatening conditions may require immediate emergency surgery, a full assessment of shared structures should be performed before separation is attempted. […] Not all conjoined twins are candidates for separation, and the success rates for separating conjoined twins vary depending on the connection. […] Childrens Hospital of Philadelphia has successfully separated 32 pairs of conjoined twins, the first in 1957.

• #58 Conjoined Twins | Children’s Hospital Colorado

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

  A routine ultrasound is the most common form of diagnosis for conjoined twins. […] MRI and echocardiogram are used to provide additional details. […] The more we know about the anatomy and how precisely the two babies are joined, the more accurately our team can assess whether surgically separating the twins is possible, and if so, how best to proceed. […] Understandably, this is a very upsetting diagnosis. […] Successful surgical separation after birth is possible, but the outcomes depend on the type of connection as well as which organs and body structures are shared. […] There are no surgical procedures that can be performed while the babies are still in the uterus (referred to as fetal interventions) to separate conjoined twins. […] Twins whose lives are immediately threatened, especially those connected at the chest or head, require emergency surgery before extensive diagnostics can be completed. […] 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.

• #59 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. […] While some life-threatening conditions may require immediate emergency surgery, a full assessment of shared structures should be performed before separation is attempted. […] Not all conjoined twins are candidates for separation, and the success rates for separating conjoined twins vary depending on the connection. […] Childrens Hospital of Philadelphia has successfully separated 32 pairs of conjoined twins, the first in 1957.

• #60 Conjoined Twins – Greater Accra Regional Hospital

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

  Indicators of conjoined twins include the lack of a separating membrane between the twins, inability to separate the fetal bodies, and constant position of the fetal heads. […] 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. […] When the conjoined twins share a heart, successful surgical division is usually not possible.

• #61 Internet Scientific Publications

  http://ispub.com/IJGO/12/2/7486

  Diagnostic criteria proposed include: absent separating membrane, conjoined body parts, inseparable bodies or heads despite changes in fetal position, bifid appearance of the fetal pole in the first trimester, more than three vessels in the umbilical cord, complex structural anomalies, heads or bodies at the same level, hyperextended spine, unusual proximity of the extremities, persistence of the relative positions after movement or at the follow-up scan. […] Recent reports have also presented data on the contribution of 3D ultrasonography to the antenatal diagnosis of conjoined twins. […] Detailed evaluation of the degree of union and number of shared organs is required to predict the viability and prognosis of the fetuses. […] Magnetic resonance imaging and computed tomography both provide excellent anatomic and bone detail, demonstrating organ position, shared viscera, and limited vascular anatomy, but the consensus appears to be that optimal evaluation is obtained with a combination of ultrasound and magnetic resonance imaging. […] Where the prognosis is poor, early diagnosis enables proper counselling of the family and gives the parents the option of termination.

• #62 Conjoined Twins – Greater Accra Regional Hospital

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

  Indicators of conjoined twins include the lack of a separating membrane between the twins, inability to separate the fetal bodies, and constant position of the fetal heads. […] 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. […] When the conjoined twins share a heart, successful surgical division is usually not possible.

• #63 Conjoined Twins – Greater Accra Regional Hospital

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

  Indicators of conjoined twins include the lack of a separating membrane between the twins, inability to separate the fetal bodies, and constant position of the fetal heads. […] 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. […] When the conjoined twins share a heart, successful surgical division is usually not possible.

• #64 Conjoined twins – role of imaging and recent advances

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5769666/

  Conjoined twins are identical twins with fused bodies, joined in utero. They are rare complications of monochorionic twinning. The purpose of this study is to describe the various types of conjoined twins, the role of imaging and recent advances aiding in their management. […] All the 3 cases were identified antenatally by ultrasound. Only one case was further evaluated by MRI. […] Three cases of conjoined twins (cephalopagus, thoracopagus and omphalopagus) were accurately diagnosed on antenatal ultrasound. […] Ultrasound enables an early and accurate diagnosis of conjoined twins, which is vital for obstetric management. MRI is reserved for better tissue characterization. […] Recent advances, such as 3D printing, may aid in surgical pre-planning, thereby enabling successful surgical separation of conjoined twins.

• #65 Conjoined twins – role of imaging and recent advances

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5769666/

  Conjoined twins are identical twins with fused bodies, joined in utero. They are rare complications of monochorionic twinning. The purpose of this study is to describe the various types of conjoined twins, the role of imaging and recent advances aiding in their management. […] All the 3 cases were identified antenatally by ultrasound. Only one case was further evaluated by MRI. […] Three cases of conjoined twins (cephalopagus, thoracopagus and omphalopagus) were accurately diagnosed on antenatal ultrasound. […] Ultrasound enables an early and accurate diagnosis of conjoined twins, which is vital for obstetric management. MRI is reserved for better tissue characterization. […] Recent advances, such as 3D printing, may aid in surgical pre-planning, thereby enabling successful surgical separation of conjoined twins.

• #66 Journal of Ultrasonography

  https://jultrason.pl/index.php/wydawnictwa/volume-17-no-71/conjoined-twins-role-of-imaging-and-recent-advances

  Conjoined twins are identical twins with fused bodies, joined in utero. They are rare complications of monochorionic twinning. The purpose of this study is to describe the various types of conjoined twins, the role of imaging and recent advances aiding in their management. […] All the 3 cases were identified antenatally by ultrasound. Only one case was further evaluated by MRI. […] Three cases of conjoined twins (cephalopagus, thoracopagus and omphalopagus) were accurately diagnosed on antenatal ultrasound. […] Ultrasound enables an early and accurate diagnosis of conjoined twins, which is vital for obstetric management. MRI is reserved for better tissue characterization. […] Recent advances, such as 3D printing, may aid in surgical pre-planning, thereby enabling successful surgical separation of conjoined twins.

• #67 Antenatal Diagnosis of Parapagus Conjoined Twins: 3D Virtual and 3D Physical Models – Revista Brasileira de Ginecologia e Obstetrícia

  https://journalrbgo.org/article/antenatal-diagnosis-of-parapagus-conjoined-twins-3d-virtual-and-3d-physical-models/

  Conjoined twins (CTs) are a rare complication from monochorionic and monoamniotic twin pregnancies. […] A 16-year-old G1P0 woman was referred for fetal magnetic resonance imaging (MRI) anatomical evaluation of a CT at 28 weeks of gestation. […] 3D technologies are an important tool for parental counseling and preparation of the multidisciplinary care team for delivery and neonatal assistance and possible surgical planning for postnatal separation in CTs cases.

• #68 Conjoined twins – role of imaging and recent advances

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5769666/

  Imaging plays a crucial role in the antenatal and postnatal life of conjoined twins, with the initial modality for screening being ultrasound followed by other modalities such as computed tomography (CT) and/or magnetic resonance imaging (MRI). […] An antenatal diagnosis of conjoined twins can be made on ultrasound in the 1st trimester. […] Successful separation of conjoined twins requires the joint effort of a team comprising various specialists, including radiologists, obstetricians and pediatric subspecialized surgeons. […] The surgical team requires to be aware of the latest developments and available tools, such as 3D printing which will not only help them in pre-surgical planning but may also help to reduce morbidity and complications.

• #69 Antenatal Diagnosis of Parapagus Conjoined Twins: 3D Virtual and 3D Physical Models – Revista Brasileira de Ginecologia e Obstetrícia

  https://journalrbgo.org/article/antenatal-diagnosis-of-parapagus-conjoined-twins-3d-virtual-and-3d-physical-models/

  Conjoined twins (CTs) are a rare complication from monochorionic and monoamniotic twin pregnancies. […] A 16-year-old G1P0 woman was referred for fetal magnetic resonance imaging (MRI) anatomical evaluation of a CT at 28 weeks of gestation. […] 3D technologies are an important tool for parental counseling and preparation of the multidisciplinary care team for delivery and neonatal assistance and possible surgical planning for postnatal separation in CTs cases.

• #70 Antenatal Diagnosis of Parapagus Conjoined Twins: 3D Virtual and 3D Physical Models – Revista Brasileira de Ginecologia e Obstetrícia

  https://journalrbgo.org/article/antenatal-diagnosis-of-parapagus-conjoined-twins-3d-virtual-and-3d-physical-models/

  Conjoined twins (CTs) are a rare complication from monochorionic and monoamniotic twin pregnancies. […] A 16-year-old G1P0 woman was referred for fetal magnetic resonance imaging (MRI) anatomical evaluation of a CT at 28 weeks of gestation. […] 3D technologies are an important tool for parental counseling and preparation of the multidisciplinary care team for delivery and neonatal assistance and possible surgical planning for postnatal separation in CTs cases.

• #71 Detection Of Diprosopus Conjoined Twins – Case Study

  https://sonio.ai/blog/case-study-diprosopus-conjoined-twins/

  Diprosopus Conjoined Twins: Case study on the diagnosis of a rare disease. […] The ultrasound scanning revealed the following findings: intricate complexities of diprosopus conjoined twins, characterized by cranial duplication, absence of the skull vault, exencephaly, rachischisis of the cervical spine, and the striking duplication of facial features. Notably, the identification of four orbits posed a diagnostic conundrum in this rare fetal anomaly. […] The pathology and description of diprosopus-conjoined twins involve a detailed radiologic, autoptic, and histologic study to understand the structural anomalies present in these unique cases. […] Sonio stands at the forefront of prenatal ultrasound technology, offering a comprehensive AI solution, designed to streamline and automate prenatal ultrasound workflows.

• #72 Detection Of Diprosopus Conjoined Twins – Case Study

  https://sonio.ai/blog/case-study-diprosopus-conjoined-twins/

  Diprosopus Conjoined Twins: Case study on the diagnosis of a rare disease. […] The ultrasound scanning revealed the following findings: intricate complexities of diprosopus conjoined twins, characterized by cranial duplication, absence of the skull vault, exencephaly, rachischisis of the cervical spine, and the striking duplication of facial features. Notably, the identification of four orbits posed a diagnostic conundrum in this rare fetal anomaly. […] The pathology and description of diprosopus-conjoined twins involve a detailed radiologic, autoptic, and histologic study to understand the structural anomalies present in these unique cases. […] Sonio stands at the forefront of prenatal ultrasound technology, offering a comprehensive AI solution, designed to streamline and automate prenatal ultrasound workflows.

• #73 Early ultrasound diagnosis of conjoined twins at eight weeks of pregnancy: A case report

  https://www.wjgnet.com/2307-8960/full/v8/i21/5389.htm

  Herein we report a case of conjoined twins suspected of cardiac fusion diagnosed by prenatal ultrasound at 8 wk gestation and confirmed by surgery. […] Early diagnosis of conjoined twins has the following advantages. First, through the early evaluation of the degree of fusion, the optimal treatment time and strategy can be selected. […] Early evaluation will also help parents to choose early termination, thereby reducing the risk of trauma during vaginal delivery. […] This study suggests that active and regular antenatal ultrasonic examinations provide a great opportunity for good prognosis. […] We suppose that an ultrasound examination at 7-8 wk of pregnancy plays an important role in the early diagnosis of congenital malformations in twins.

• #74 Early ultrasound diagnosis of conjoined twins at eight weeks of pregnancy: A case report

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7674739/

  Herein we report a case of conjoined twins suspected of cardiac fusion diagnosed by prenatal ultrasound at 8 wk gestation and confirmed by surgery. […] Early diagnosis of conjoined twins has the following advantages. First, through the early evaluation of the degree of fusion, the optimal treatment time and strategy can be selected. […] Early evaluation will also help parents to choose early termination, thereby reducing the risk of trauma during vaginal delivery. […] This study suggests that active and regular antenatal ultrasonic examinations provide a great opportunity for good prognosis. […] We suppose that an ultrasound examination at 7-8 wk of pregnancy plays an important role in the early diagnosis of congenital malformations in twins.

• #75 Antenatal diagnosis of thoracopagus and thoraco-omphalopagus conjoined twins: case series | Egyptian Journal of Radiology and Nuclear Medicine | Full Text

  https://ejrnm.springeropen.com/articles/10.1186/s43055-023-01152-4

  Conjoined twin pregnancy is a rare variety, which occurs due to incomplete separation of the embryonic plate after 13 days. […] So a comprehensive multidisciplinary prenatal assessment of conjoined twins is crucial for providing accurate parental counseling, effectively managing the pregnancy, and formulating an appropriate delivery strategy. […] The purpose of our study was to early diagnosis of conjoined twins using ultrasound, describing the various types of conjoined twins and the role of recent advances like 3D ultrasound in aiding their management. […] Four cases of conjoined twins (two thoracopagus and two thoraco-omphalopagus) were accurately diagnosed on antenatal ultrasound. […] Ultrasound plays a vital role in the early diagnosis and management of conjoined twins. […] Timely antenatal screening, including ultrasound and fetal MRI, plays an important role in the early detection of conjoined and in counseling parents about potential surgical or medical termination options and outcomes.

• #76 Conjoined twins: diagnostics and obstetric tactics – medexpert

  https://med-expert.com.ua/journals/en/conjoined-twins-diagnostics-obstetric-tactics/

  Conjoined twin is a rare and complex congenital malformation with severe mortality and morbidity. The article reports a case of conjoined thoracopagus twins that were diagnosed by ultrasonography at the 3rd trimester of pregnancy. […] The early diagnosis of conjoined twins allows providing reasonable obstetric tactics and informing parents about options for monitoring, abortion on therapeutic grounds (including selective feticide with triple), delivery time and its mode if a decision of pregnancy prolongation is made. […] Diagnosis of conjoined twins should be carried out at the first trimester of pregnancy. Provision of perinatal care for this pathology should be carried out in a maternity institution with a compulsory participation of a multidisciplinary team of neonatologists, intensivists, pediatric surgeons.

• #77 The Fetal Medicine Foundation

  https://fetalmedicine.org/education/fetal-abnormalities/multiple-pregnancies/mc-twins-conjoined-twins

  Detailed ultrasound examination and assessment by multidisciplinary team. […] Management: […] Pregnancy termination, stillbirth or neonatal death in 90% of cases. […] If the pregnancy continues, delivery should be by cesarean section in a centre with expertise in the management of such pregnancies. […] Prognosis: […] Very high risk of handicap in survivors. […] Recurrence: […] No increased risk of recurrence.

• #78 Internet Scientific Publications

  http://ispub.com/IJGO/12/2/7486

  Diagnostic criteria proposed include: absent separating membrane, conjoined body parts, inseparable bodies or heads despite changes in fetal position, bifid appearance of the fetal pole in the first trimester, more than three vessels in the umbilical cord, complex structural anomalies, heads or bodies at the same level, hyperextended spine, unusual proximity of the extremities, persistence of the relative positions after movement or at the follow-up scan. […] Recent reports have also presented data on the contribution of 3D ultrasonography to the antenatal diagnosis of conjoined twins. […] Detailed evaluation of the degree of union and number of shared organs is required to predict the viability and prognosis of the fetuses. […] Magnetic resonance imaging and computed tomography both provide excellent anatomic and bone detail, demonstrating organ position, shared viscera, and limited vascular anatomy, but the consensus appears to be that optimal evaluation is obtained with a combination of ultrasound and magnetic resonance imaging. […] Where the prognosis is poor, early diagnosis enables proper counselling of the family and gives the parents the option of termination.

• #79 Antenatal diagnosis of thoracopagus and thoraco-omphalopagus conjoined twins: case series | Egyptian Journal of Radiology and Nuclear Medicine | Full Text

  https://ejrnm.springeropen.com/articles/10.1186/s43055-023-01152-4

  Conjoined twin pregnancy is a rare variety, which occurs due to incomplete separation of the embryonic plate after 13 days. […] So a comprehensive multidisciplinary prenatal assessment of conjoined twins is crucial for providing accurate parental counseling, effectively managing the pregnancy, and formulating an appropriate delivery strategy. […] The purpose of our study was to early diagnosis of conjoined twins using ultrasound, describing the various types of conjoined twins and the role of recent advances like 3D ultrasound in aiding their management. […] Four cases of conjoined twins (two thoracopagus and two thoraco-omphalopagus) were accurately diagnosed on antenatal ultrasound. […] Ultrasound plays a vital role in the early diagnosis and management of conjoined twins. […] Timely antenatal screening, including ultrasound and fetal MRI, plays an important role in the early detection of conjoined and in counseling parents about potential surgical or medical termination options and outcomes.

• #80 Conjoined twins in dichorionic diamniotic triplet pregnancy: a report of three cases and literature review | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-021-04165-x

  Prenatal screening and diagnosis of conjoined twins is usually performed by ultrasonography. MRI can be used to assist in the diagnosis if necessary. […] Conjoined twins have a low survival rate, and the prognosis is generally poor. Twenty-five percent of live births live to the age of surgery. Only 60% of surgical separation cases survive; therefore, early antenatal diagnosis is important. […] Early antenatal diagnosis of conjoined twins and determination of chorionicity of triplet gestations are critical for individualized management options and the prognosis of the normal fetus. Expecting parents should be extensively counseled by a multidisciplinary team. Early selective termination of the conjoined twins by intrathoracic injection of potassium chloride may be a procedure in dichorionic diamniotic triplet pregnancies to improve the perinatal outcomes of the normal fetus in triplets.

• #81 Early ultrasound diagnosis of conjoined twins at eight weeks of pregnancy: A case report

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7674739/

  Herein we report a case of conjoined twins suspected of cardiac fusion diagnosed by prenatal ultrasound at 8 wk gestation and confirmed by surgery. […] Early diagnosis of conjoined twins has the following advantages. First, through the early evaluation of the degree of fusion, the optimal treatment time and strategy can be selected. […] Early evaluation will also help parents to choose early termination, thereby reducing the risk of trauma during vaginal delivery. […] This study suggests that active and regular antenatal ultrasonic examinations provide a great opportunity for good prognosis. […] We suppose that an ultrasound examination at 7-8 wk of pregnancy plays an important role in the early diagnosis of congenital malformations in twins.

• #82 Antenatal diagnosis and prognosis of conjoined twins – a case report

  https://www.degruyterbrill.com/_language/de?uri=%2Fdocument%2Fdoi%2F10.1515%2FJPM.2003.066%2Fhtml&srsltid=AfmBOoqBZI04dUC46-V-sDwKa29cgDf0YJ-Zn5qCv0FFNcqX8rqQ4S7g

  In this report, two conjoined twin cases that were diagnosed at the 19th and 25th week of gestational age are reported. […] In the first case the pregnancy was terminated because of the very poor prognosis. […] In the second case the decision was made to continue the pregnancy after counseling explaining the possibility of a separation procedure with good prognosis being carried out after birth. […] In selected cases, there is no need to abort, because of the possibility of a separation procedure after birth with good prognosis. […] Color Doppler ultrasound examination in an early stage of pregnancy in cases of conjoined twin can make it possible to decide which cases are candidates for a separation procedure after birth.

• #83 📃 History, classification, and two cases of conjoined twins

  https://thefetus.net/content/history-classification-and-two-cases-of-conjoined-twins

  Conjoined twins occur in approximately 0.2:10,000 births. […] The authors report two cases: (1) discovery at 13 weeks gestational age of omphalopagus twins; and (2) birth of conjoined twins at 35 weeks gestation. […] Sonography has demonstrated conjoined twins at the end of the first trimester since 1995. […] In 1995, Maggio reported a diagnosis of conjoined twins (thoracopagus with a single heart) at 8 weeks, 5 days, confirmed at 13 weeks gestational age. […] Early sonography shows continuity between the fetuses and fails to show independent movement. […] Diagnosis of conjoined twins is possible as early as 8 weeks gestation, but accurate evaluation of common structures is not possible. […] The 12-week scan allows clinicians to assess viability, and, in the case of nonviability, to propose early medical interruption of pregnancy, preventing hysterotomy in the case of a delayed termination. […] Early discovery of viable conjoined twins permits assessment of the best route of delivery and a planning for serial sonography and fast MRI to plan separation surgery.

• #84 Early ultrasound diagnosis of conjoined twins at eight weeks of pregnancy: A case report

  https://www.wjgnet.com/2307-8960/full/v8/i21/5389.htm

  Herein we report a case of conjoined twins suspected of cardiac fusion diagnosed by prenatal ultrasound at 8 wk gestation and confirmed by surgery. […] Early diagnosis of conjoined twins has the following advantages. First, through the early evaluation of the degree of fusion, the optimal treatment time and strategy can be selected. […] Early evaluation will also help parents to choose early termination, thereby reducing the risk of trauma during vaginal delivery. […] This study suggests that active and regular antenatal ultrasonic examinations provide a great opportunity for good prognosis. […] We suppose that an ultrasound examination at 7-8 wk of pregnancy plays an important role in the early diagnosis of congenital malformations in twins.

• #85 Parasitic Twin: Causes, Diagnosis & Removal

  https://my.clevelandclinic.org/health/diseases/23513-parasitic-twin

  A parasitic twin is a type of conjoined twin where one fetus stops developing but remains attached to its twin. […] A parasitic twin is a rare condition that happens when a conjoined twin stops developing. […] A parasitic twin is also known as asymmetrical or unequal conjoined twins, vestigial twins, fetus in fetu, and heteropagus twins. […] A parasitic twin is a type of conjoined twin. It accounts for about 10% of all conjoined twins. […] A parasitic twin is very rare. It affects less than 1 in 1 million births worldwide. […] Your healthcare provider may diagnose parasitic twins in a prenatal ultrasound. […] If a parasitic twin is suspected, an echocardiogram may be necessary to determine if the parasitic twin is putting strain on the autositic (dominant) twins heart. […] Surgical removal of the parasitic twin from the dominant twin is necessary.

• #86 Parasitic Twin: Causes, Diagnosis & Removal

  https://my.clevelandclinic.org/health/diseases/23513-parasitic-twin

  A parasitic twin is a type of conjoined twin where one fetus stops developing but remains attached to its twin. […] A parasitic twin is a rare condition that happens when a conjoined twin stops developing. […] A parasitic twin is also known as asymmetrical or unequal conjoined twins, vestigial twins, fetus in fetu, and heteropagus twins. […] A parasitic twin is a type of conjoined twin. It accounts for about 10% of all conjoined twins. […] A parasitic twin is very rare. It affects less than 1 in 1 million births worldwide. […] Your healthcare provider may diagnose parasitic twins in a prenatal ultrasound. […] If a parasitic twin is suspected, an echocardiogram may be necessary to determine if the parasitic twin is putting strain on the autositic (dominant) twins heart. […] Surgical removal of the parasitic twin from the dominant twin is necessary.

• #87 Parasitic Twin: Causes, Diagnosis & Removal

  https://my.clevelandclinic.org/health/diseases/23513-parasitic-twin

  A parasitic twin is a type of conjoined twin where one fetus stops developing but remains attached to its twin. […] A parasitic twin is a rare condition that happens when a conjoined twin stops developing. […] A parasitic twin is also known as asymmetrical or unequal conjoined twins, vestigial twins, fetus in fetu, and heteropagus twins. […] A parasitic twin is a type of conjoined twin. It accounts for about 10% of all conjoined twins. […] A parasitic twin is very rare. It affects less than 1 in 1 million births worldwide. […] Your healthcare provider may diagnose parasitic twins in a prenatal ultrasound. […] If a parasitic twin is suspected, an echocardiogram may be necessary to determine if the parasitic twin is putting strain on the autositic (dominant) twins heart. […] Surgical removal of the parasitic twin from the dominant twin is necessary.

• #88 Parasitic Twin: Causes, Diagnosis & Removal

  https://my.clevelandclinic.org/health/diseases/23513-parasitic-twin

  A parasitic twin is a type of conjoined twin where one fetus stops developing but remains attached to its twin. […] A parasitic twin is a rare condition that happens when a conjoined twin stops developing. […] A parasitic twin is also known as asymmetrical or unequal conjoined twins, vestigial twins, fetus in fetu, and heteropagus twins. […] A parasitic twin is a type of conjoined twin. It accounts for about 10% of all conjoined twins. […] A parasitic twin is very rare. It affects less than 1 in 1 million births worldwide. […] Your healthcare provider may diagnose parasitic twins in a prenatal ultrasound. […] If a parasitic twin is suspected, an echocardiogram may be necessary to determine if the parasitic twin is putting strain on the autositic (dominant) twins heart. […] Surgical removal of the parasitic twin from the dominant twin is necessary.

• #89 Parasitic Twin: Causes, Diagnosis & Removal

  https://my.clevelandclinic.org/health/diseases/23513-parasitic-twin

  A parasitic twin is a type of conjoined twin where one fetus stops developing but remains attached to its twin. […] A parasitic twin is a rare condition that happens when a conjoined twin stops developing. […] A parasitic twin is also known as asymmetrical or unequal conjoined twins, vestigial twins, fetus in fetu, and heteropagus twins. […] A parasitic twin is a type of conjoined twin. It accounts for about 10% of all conjoined twins. […] A parasitic twin is very rare. It affects less than 1 in 1 million births worldwide. […] Your healthcare provider may diagnose parasitic twins in a prenatal ultrasound. […] If a parasitic twin is suspected, an echocardiogram may be necessary to determine if the parasitic twin is putting strain on the autositic (dominant) twins heart. […] Surgical removal of the parasitic twin from the dominant twin is necessary.

• #90 Parasitic Twin: Causes, Diagnosis & Removal

  https://my.clevelandclinic.org/health/diseases/23513-parasitic-twin

  A parasitic twin isn’t alive and dies in the womb while attached to the dominant twin. […] The parasitic twin doesn’t survive the pregnancy. The dominant twin is fully developed and typically survives. […] A parasitic twin is a rare type of conjoined twin. It occurs when a partially formed fetus attaches to another fetus (its twin) very early in development.

• #91 Parasitic Twin: Causes, Diagnosis & Removal

  https://my.clevelandclinic.org/health/diseases/23513-parasitic-twin

  A parasitic twin is a type of conjoined twin where one fetus stops developing but remains attached to its twin. […] A parasitic twin is a rare condition that happens when a conjoined twin stops developing. […] A parasitic twin is also known as asymmetrical or unequal conjoined twins, vestigial twins, fetus in fetu, and heteropagus twins. […] A parasitic twin is a type of conjoined twin. It accounts for about 10% of all conjoined twins. […] A parasitic twin is very rare. It affects less than 1 in 1 million births worldwide. […] Your healthcare provider may diagnose parasitic twins in a prenatal ultrasound. […] If a parasitic twin is suspected, an echocardiogram may be necessary to determine if the parasitic twin is putting strain on the autositic (dominant) twins heart. […] Surgical removal of the parasitic twin from the dominant twin is necessary.

• #92 Conjoined twins in dichorionic diamniotic triplet pregnancy: a report of three cases and literature review | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-021-04165-x

  Conjoined twins are a rare and serious complication of monochorionic twins. The total incidence is 1.5 per 100,000 births, and about 50% are liveborn. Prenatal screening and diagnosis of conjoined twins is usually performed by ultrasonography. Magnetic resonance imaging can be used to assist in the diagnosis if necessary. Conjoined twins in dichorionic diamniotic triplet pregnancy are extremely rare. […] Surgical separation is the only treatment for conjoined twins after birth. Early determination of chorionicity and antenatal diagnosis of conjoined twins in triplet gestations are critical for individualized management options and the prognosis of normal triplets. Expecting parents should be extensively counseled by multidisciplinary teams. If there are limitations in successful separation after birth, early selective termination of the conjoined twins by intrathoracic injection of potassium chloride may be a procedure in dichorionic diamniotic triplet pregnancy to improve perinatal outcomes of the normal triplet.

• #93 Conjoined twins in dichorionic diamniotic triplet pregnancy: a report of three cases and literature review | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-021-04165-x

  Conjoined twins are a rare and serious complication of monochorionic twins. The total incidence is 1.5 per 100,000 births, and about 50% are liveborn. Prenatal screening and diagnosis of conjoined twins is usually performed by ultrasonography. Magnetic resonance imaging can be used to assist in the diagnosis if necessary. Conjoined twins in dichorionic diamniotic triplet pregnancy are extremely rare. […] Surgical separation is the only treatment for conjoined twins after birth. Early determination of chorionicity and antenatal diagnosis of conjoined twins in triplet gestations are critical for individualized management options and the prognosis of normal triplets. Expecting parents should be extensively counseled by multidisciplinary teams. If there are limitations in successful separation after birth, early selective termination of the conjoined twins by intrathoracic injection of potassium chloride may be a procedure in dichorionic diamniotic triplet pregnancy to improve perinatal outcomes of the normal triplet.

• #94 Conjoined twins in dichorionic diamniotic triplet pregnancy: a report of three cases and literature review | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-021-04165-x

  Conjoined twins are a rare and serious complication of monochorionic twins. The total incidence is 1.5 per 100,000 births, and about 50% are liveborn. Prenatal screening and diagnosis of conjoined twins is usually performed by ultrasonography. Magnetic resonance imaging can be used to assist in the diagnosis if necessary. Conjoined twins in dichorionic diamniotic triplet pregnancy are extremely rare. […] Surgical separation is the only treatment for conjoined twins after birth. Early determination of chorionicity and antenatal diagnosis of conjoined twins in triplet gestations are critical for individualized management options and the prognosis of normal triplets. Expecting parents should be extensively counseled by multidisciplinary teams. If there are limitations in successful separation after birth, early selective termination of the conjoined twins by intrathoracic injection of potassium chloride may be a procedure in dichorionic diamniotic triplet pregnancy to improve perinatal outcomes of the normal triplet.

• #95 Conjoined twins in dichorionic diamniotic triplet pregnancy: a report of three cases and literature review | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-021-04165-x

  Prenatal screening and diagnosis of conjoined twins is usually performed by ultrasonography. MRI can be used to assist in the diagnosis if necessary. […] Conjoined twins have a low survival rate, and the prognosis is generally poor. Twenty-five percent of live births live to the age of surgery. Only 60% of surgical separation cases survive; therefore, early antenatal diagnosis is important. […] Early antenatal diagnosis of conjoined twins and determination of chorionicity of triplet gestations are critical for individualized management options and the prognosis of the normal fetus. Expecting parents should be extensively counseled by a multidisciplinary team. Early selective termination of the conjoined twins by intrathoracic injection of potassium chloride may be a procedure in dichorionic diamniotic triplet pregnancies to improve the perinatal outcomes of the normal fetus in triplets.

• #96 Conjoined twins in a triplet pregnancy | Saudi Medical Journal

  https://smj.org.sa/content/38/3/307

  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. […] In conclusion, triplet conjoined twins is a unique phenomenon. In each case of triplet pregnancies, the clinician should be aware about the possibility of conjoined twins. If there are severe congenital malformations, termination of pregnancy should be recommended immediately after the diagnosis regardless of gestational age, particularly in early gestational age.

• #97 Conjoined twins in a triplet pregnancy | Saudi Medical Journal

  https://smj.org.sa/content/38/3/307

  Conjoined twins are derived from division of a single fertilized ovum after the twelfth day of fertilization. Triplet conjoined twin is considered as a unique phenomenon that is accompanied with a wide variety of congenital abnormalities and also hazardous consequences for both fetuses and parents. […] In triplet pregnancies, we should be aware about the possibility of conjoined twins. If there are severe congenital malformations, termination of pregnancy should be recommended immediately after the diagnosis regardless of gestational age, particularly in early gestational age. […] Today, most of the cases are diagnosed in prenatal period using ultrasonography. This scanning procedure allows counseling of the family about the management options, including termination of the whole pregnancy, selective feticide of the conjoined twins or continuing the pregnancy.

• #98 Conjoined twins – role of imaging and recent advances

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5769666/

  Imaging plays a crucial role in the antenatal and postnatal life of conjoined twins, with the initial modality for screening being ultrasound followed by other modalities such as computed tomography (CT) and/or magnetic resonance imaging (MRI). […] An antenatal diagnosis of conjoined twins can be made on ultrasound in the 1st trimester. […] Successful separation of conjoined twins requires the joint effort of a team comprising various specialists, including radiologists, obstetricians and pediatric subspecialized surgeons. […] The surgical team requires to be aware of the latest developments and available tools, such as 3D printing which will not only help them in pre-surgical planning but may also help to reduce morbidity and complications.

• #99 Conjoined twins – role of imaging and recent advances

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5769666/

  Imaging plays a crucial role in the antenatal and postnatal life of conjoined twins, with the initial modality for screening being ultrasound followed by other modalities such as computed tomography (CT) and/or magnetic resonance imaging (MRI). […] An antenatal diagnosis of conjoined twins can be made on ultrasound in the 1st trimester. […] Successful separation of conjoined twins requires the joint effort of a team comprising various specialists, including radiologists, obstetricians and pediatric subspecialized surgeons. […] The surgical team requires to be aware of the latest developments and available tools, such as 3D printing which will not only help them in pre-surgical planning but may also help to reduce morbidity and complications.

• #100 Conjoined twins: diagnostics and obstetric tactics – medexpert

  https://med-expert.com.ua/journals/en/conjoined-twins-diagnostics-obstetric-tactics/

  Conjoined twin is a rare and complex congenital malformation with severe mortality and morbidity. The article reports a case of conjoined thoracopagus twins that were diagnosed by ultrasonography at the 3rd trimester of pregnancy. […] The early diagnosis of conjoined twins allows providing reasonable obstetric tactics and informing parents about options for monitoring, abortion on therapeutic grounds (including selective feticide with triple), delivery time and its mode if a decision of pregnancy prolongation is made. […] Diagnosis of conjoined twins should be carried out at the first trimester of pregnancy. Provision of perinatal care for this pathology should be carried out in a maternity institution with a compulsory participation of a multidisciplinary team of neonatologists, intensivists, pediatric surgeons.

• #101 Conjoined twins: diagnostics and obstetric tactics – medexpert

  https://med-expert.com.ua/journals/en/conjoined-twins-diagnostics-obstetric-tactics/

  Conjoined twin is a rare and complex congenital malformation with severe mortality and morbidity. The article reports a case of conjoined thoracopagus twins that were diagnosed by ultrasonography at the 3rd trimester of pregnancy. […] The early diagnosis of conjoined twins allows providing reasonable obstetric tactics and informing parents about options for monitoring, abortion on therapeutic grounds (including selective feticide with triple), delivery time and its mode if a decision of pregnancy prolongation is made. […] Diagnosis of conjoined twins should be carried out at the first trimester of pregnancy. Provision of perinatal care for this pathology should be carried out in a maternity institution with a compulsory participation of a multidisciplinary team of neonatologists, intensivists, pediatric surgeons.

• #102 Conjoined twins | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/conjoined-twins?lang=us

  Conjoined twin pregnancy is a rare occurrence resulting from the failure of a zygote to separate completely after 13 days. […] The prevalence of conjoined twins ranges from 1:50,000 to 1:200,000. […] Conjoined twins are monozygotic, monoamniotic, and monochorionic (MCMA) and result due to a failure of normal complete separation of the embryonic plate from an incomplete delayed division of the inner cell mass. […] Thus identification of a dividing membrane or two placentas excludes the diagnosis. […] The prognosis for conjoined twins, in general, is quite poor. Approximately 40-60% of conjoined twins are stillborn and almost 35% of live births do not survive beyond 24 hours. Of those who do survive, surgical separation is sometimes possible.

• #103 Conjoined twins | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/conjoined-twins?lang=us

  Conjoined twin pregnancy is a rare occurrence resulting from the failure of a zygote to separate completely after 13 days. […] The prevalence of conjoined twins ranges from 1:50,000 to 1:200,000. […] Conjoined twins are monozygotic, monoamniotic, and monochorionic (MCMA) and result due to a failure of normal complete separation of the embryonic plate from an incomplete delayed division of the inner cell mass. […] Thus identification of a dividing membrane or two placentas excludes the diagnosis. […] The prognosis for conjoined twins, in general, is quite poor. Approximately 40-60% of conjoined twins are stillborn and almost 35% of live births do not survive beyond 24 hours. Of those who do survive, surgical separation is sometimes possible.

• #104 Conjoined twins – role of imaging and recent advances

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5769666/

  Imaging plays a crucial role in the antenatal and postnatal life of conjoined twins, with the initial modality for screening being ultrasound followed by other modalities such as computed tomography (CT) and/or magnetic resonance imaging (MRI). […] An antenatal diagnosis of conjoined twins can be made on ultrasound in the 1st trimester. […] Successful separation of conjoined twins requires the joint effort of a team comprising various specialists, including radiologists, obstetricians and pediatric subspecialized surgeons. […] The surgical team requires to be aware of the latest developments and available tools, such as 3D printing which will not only help them in pre-surgical planning but may also help to reduce morbidity and complications.

• #105 Early ultrasound diagnosis of conjoined twins at eight weeks of pregnancy: A case report

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7674739/

  Conjoined twins are a rare occurrence, and the majority of these malformations are detected during second trimester screening. […] Herein we report a case of conjoined twins, which was diagnosed by ultrasound at 8 wk gestation and was normal at 7 wk gestation. The two fetuses shared one heart and were diagnosed as thoracopagus twins. This is the first report of conjoined twins diagnosed at 8 wk gestation. […] Because some congenital malformations can be diagnosed earlier, a prenatal ultrasound examination at an early gestational stage cannot be dismissed. […] This case demonstrates that a 7-8 wk gestation might be the earliest period when conjoined twins can be diagnosed by ultrasound. […] We found that ultrasound examination at 7-8 wk of pregnancy plays an important role in the early diagnosis of congenital malformation in twins.

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

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

  Conjoined twins are typically diagnosed early in pregnancy with prenatal ultrasound. The optimal evaluation period for additional prenatal testing is after 18 weeks gestation. […] 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. […] Prenatal diagnosis will help identify the optimal treatment and delivery plan, and the potential for separation after birth. […] The following imaging tests are used to diagnose and evaluate conjoined twins: Fetal ultrasound, Fetal echocardiogram, Ultrafast fetal MRI. […] Indicators of conjoined twins include lack of a separating membrane between the twins, inability to separate the fetal bodies, and constant position of the fetal heads.

• #107 Prenatal diagnosis of non-janiceps type of cephalopagus conjoined twins: a case report | Egyptian Journal of Radiology and Nuclear Medicine | Full Text

  https://ejrnm.springeropen.com/articles/10.1186/s43055-023-01008-x

  High level of suspicion is required to diagnose such cases on an ultrasound. One can diagnose a conjoined twin pregnancy as early as at 12 weeks of gestation. […] 3-D ultrasound can help in determining the extent of fusion of conjoined twins and thus help in proper classification, which would further help in appropriate management. […] Fetal MRI can help as a complimentary mode of investigation to the ultrasound as it can give reproducible fetal anatomy with better and detailed delineation of the associated congenital fetal abnormalities. […] Now with the advent of 3-D ultrasound techniques and faster MRI sequences, early prenatal diagnosis and appropriate classification of conjoined twins has become easier for optimal and timely obstetric as well as post natal management.

• #108 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. […] While some life-threatening conditions may require immediate emergency surgery, a full assessment of shared structures should be performed before separation is attempted. […] Not all conjoined twins are candidates for separation, and the success rates for separating conjoined twins vary depending on the connection. […] Childrens Hospital of Philadelphia has successfully separated 32 pairs of conjoined twins, the first in 1957.

• #109 Conjoined Twins: Definition, Causes & Outlook

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

  After conjoined twins are born, they are grouped into one of three categories: No separation: If separation would pose life-threatening risks to the twins or result in extreme disabilities, surgical separation would only be attempted after consideration of all quality-of-life issues. Immediate separation: Sometimes emergency surgical separation is required to save the life of one and/or both twins. Delayed separation: When the twins are stable from a health standpoint, your medical team may delay separation surgery. […] Since the cause of conjoined twins is unknown, theres no way to prevent conjoined twins from occurring during pregnancy. […] Survival rates and quality of life for conjoined twins depend entirely on how the two babies are connected. […] If separation surgery is attempted, only 60% of surgically separated conjoined twins survive. Healthcare providers can manage complications to improve the outlook for conjoined twins.

• #110 Diagnosis and Management of Conjoined Twins | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-030-47652-6_19

  Conjoined twins (CT) are a rare complication of monoamniotic twinning. […] Ultrasound, 3D ultrasound, and magnetic resonance imaging are critical for antenatal diagnosis, careful analysis of the area of fusion, and subsequent prognostication. […] Only a minority of twins that survive birth will go on to be candidates for surgical separation. […] Surgical separation should only be attempted at centers with expertise in these procedures, which are complex and frequently associated with residual morbidity. […] Because the ethical considerations of surgical separation are complex, a palliative care team is critical for understanding patient and her family’s goals and preferences.

• #111 Diagnosis and Management of Conjoined Twins | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-030-47652-6_19

  Conjoined twins (CT) are a rare complication of monoamniotic twinning. […] Ultrasound, 3D ultrasound, and magnetic resonance imaging are critical for antenatal diagnosis, careful analysis of the area of fusion, and subsequent prognostication. […] Only a minority of twins that survive birth will go on to be candidates for surgical separation. […] Surgical separation should only be attempted at centers with expertise in these procedures, which are complex and frequently associated with residual morbidity. […] Because the ethical considerations of surgical separation are complex, a palliative care team is critical for understanding patient and her family’s goals and preferences.

• #112 Antenatal diagnosis of thoracopagus and thoraco-omphalopagus conjoined twins: case series | Egyptian Journal of Radiology and Nuclear Medicine | Full Text

  https://ejrnm.springeropen.com/articles/10.1186/s43055-023-01152-4

  Conjoined twin pregnancy is a rare variety, which occurs due to incomplete separation of the embryonic plate after 13 days. […] So a comprehensive multidisciplinary prenatal assessment of conjoined twins is crucial for providing accurate parental counseling, effectively managing the pregnancy, and formulating an appropriate delivery strategy. […] The purpose of our study was to early diagnosis of conjoined twins using ultrasound, describing the various types of conjoined twins and the role of recent advances like 3D ultrasound in aiding their management. […] Four cases of conjoined twins (two thoracopagus and two thoraco-omphalopagus) were accurately diagnosed on antenatal ultrasound. […] Ultrasound plays a vital role in the early diagnosis and management of conjoined twins. […] Timely antenatal screening, including ultrasound and fetal MRI, plays an important role in the early detection of conjoined and in counseling parents about potential surgical or medical termination options and outcomes.

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