Conjoined Thoracopagus Twins - Our Experience of Successful Separation

Thoraco-Omphalopagus Conjoined Twins: A Case Report

A conjoined twin is an uncommon congenital condition that has a very high morbidity and mortality prevalence. Identical twins united in utero are known as conjoined twins. It's an uncommon occurrence that poses a special difficulty for paediatric surgeons and obstetricians. Conjoined twins are a complicated by-product of monozygotic twinning, which raises the risk of death in the womb. One of the more prevalent varieties of conjoined twins is the thoraco-omphalopagus type, in which the heart is involved in an anterior, chest-based fusion. This case involves a 26-year-old woman who was diagnosed at 19 weeks with conjoined thoraco-omphalopagus twins using ultrasonography.

Conjoined thoracopagus twins: A systematic review of the anomalies and outcome of surgical separation

Introduction

Conjoined twin is an extremely rare condition and requires a thorough knowledge of anatomy, and a multidisciplinary approach is essential to successfully separate the twins. Thoracopagus twins lie face to face and are attached from chest to upper abdomen. They are the most common among all the varieties but have a poor survival rate.

Materials and Methods

This study is a review of literature from 2019 to the oldest via PubMed and Google Scholar using keywords: Conjoined twins, Thoracopagus twins, Thoracoomphalopagus and Thoraco-omphalopagus twins. The articles were reviewed for the description of the anatomy of shared organs, management and outcome of these twins.

Results

One hundred and fifty-eight sets of thoracopagus and thoraco-omphalopagus twins including our twins were included in this study. Out of 158 reported thoracopagus twin sets in literature, with M: F ratio of 1:2.3, 71 sets were found to be non-operable and all of them subsequently expired; 82 sets were operated upon, out of which 83 babies survived, suggesting an overall surgical success rate of about 50%.

Conclusion

Thoracopagus twins have a dismal prognosis. The most important decisive parameter for successful separation is the extent of sharing of organs between twins. The role of a motivated multidisciplinary team is also indispensable and cannot be overemphasised.

Thoraco-omphalopagus conjoined twin: A rare case report

Introduction and importance

Case presentation

Clinical discussion

Conclusion

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Conjoined twins epitomize rare phenomenon of monozygotic twinning.

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Associated with high rates of stillbirth and neonatal demise

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Recommended mode of delivery is cesarean section.

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Thoraco-omphalopagus linked with poorer prognosis due to complex cardiac, hepatic and biliary fusion

A Detailed Description and Discussion on Conjoined Twins

Conjoined twins are described as having been physically fused during pregnancy and delivery. They were first mentioned a long time ago when there was not much known about this. They share some organs that are vital for survival, like the heart; these twins are almost impossible to save, but there are some cases wherein there is evidence of their survival. The article aims to present a unique discussion on conjoined twins. This article talks about the formation of conjoint twins, their types and nomenclatures, embryological concepts, past history/traditional tales, case studies, and the medical enhancements happening in this area. Both fission and fusion are thought to contribute to the disease. A monozygotic twin pregnancy cleaves when it occurs more than thirteen days after fertilization. There is just one placenta and one womb for conjoined twins (one amniotic sac). The twins that are born and stay alive after delivery usually stay alive for a few days or weeks. It’s pretty rare for them to live a long prosperous life, but this article shows the otherwise, too, like the Siamese twins, which is a unique example of conjoint twins who lived for a long time. This kind of pregnancy is a complex procedure that needs to be managed by a team of professionals.