Published: 2021-04-23

A rare case of conjoined twins: craniothoraco omphalopagus-non janiceps

L. Thulasi Devi, Gurusamy Prasad


A very rare case of conjoined twins, incompatible with life. Craniothoraco omphalopagus terminated after second trimester anomalies scan. Only anecdotal case reports were available and their inheritance pattern remains a mystery. They were inoperable. Here we present such a case which was unbooked and unregistered and escaped detection till late second trimester due to non-availability of maternity services. These cases if they reached term had to be delivered always by classical caesarean due to obstructed labour and difficulty in delivery via LUS due to variety of difficulties and manoeuvrability by obstetrician. LSCS should not be attempted as it invariably leads to an inverted T scar on the uterus with increased blood loss. A classical caesarean section always leads to increased risk of future rupture and spoils the obstetric career of the woman. These cases if detected early can be delivered vaginally with ease by an experienced consultant.


Conjoined twins, Non janiceps, Lethal malformation

Full Text:



Vural F, Vural B. First trimester diagnosis of dicephalic parapagus conjoined twins via transvaginal ultrasonography. J Clin Ultrasound. 2005;33(7):364-6.

Turgut F, Turgut M, Ba┼čaloglu H, Ba┼čaloglu HK, Haberal A. Extremely rare type of conjoined twins: cephalothoracopagusderadelphus. Eur J Obstet Gynecol Reprod Biol. 1998;80(2):191-4.

Bondeson J. The Biddenden maids: a curious chapter in the history of conjoined twins. J R Soc Med. 1992;85(4):217-21.

Spencer R. Anatomic description of conjoined twins: a plea for standardized terminology. J Pediatr Surg. 1996;31(7):941-4.

Agarwal S, Kore S. Multiple Gestations: Basics and Beyond. 1st ed. India: Jaypee Brothers Medical Publishers; 2017.

Chen CP, Lee CC, Liu FF, Jan SW, Lin MH, Chen BF. Prenatal diagnosis of cephalothoracopagus janiceps monosymmetros. Prenat Diagn. 1997;17(4):384-8.

Graham GM, Gaddipati S. Diagnosis and management of obstetrical complications unique to multiple gestations. Semin Perinatol. 2005;29(5):282-95.

Stone JL, Goodrich JT. The craniopagus malformation: Classification and implications for surgical separation. Brain. 2006;129:1084-95.