Thoracopagus conjoined twin: an unusual presentation

Authors

  • Rajesh Kumari Department of Obstetrics and Gynecology, Safdarjung Hospital and VMMC, New Delhi, India
  • Renu Arora Department of Obstetrics and Gynecology, Safdarjung Hospital and VMMC, New Delhi, India
  • Nevadita Sarda Department of Obstetrics and Gynecology, Safdarjung Hospital and VMMC, New Delhi, India
  • Jyotsna Suri Department of Obstetrics and Gynecology, Safdarjung Hospital and VMMC, New Delhi, India
  • Pratima Mittal Department of Obstetrics and Gynecology, Safdarjung Hospital and VMMC, New Delhi, India

Keywords:

Conjoined twins, Laparotomy, Rupture uterus, Thoracopagus

Abstract

Conjoined twins are among rare clinical conditions observed by obstetricians. Due to rare incidence of this condition there is general lack of knowledge among obstetricians, especially at primary care level which leads to missed diagnosis during antenatal period. The management of this condition is complex especially in cases where the diagnosis is not known before onset of labour. A 30 - year old Hindu lady was referred to us from other hospital with diagnosis of twin pregnancy and prolonged second stage of labour. Clinical examination revealed findings of ruptured uterus and foetal head of one baby and feet of second baby were outside the introitus. Emergency laparotomy was done which revealed conjoined twins. This article report clinical course of a thoracopagus conjoined twin. The relevant literature is also reviewed. 

References

Kallen B, Rybo G. Conjoined twinning in Sweden. Acta Obstet Gynecol Scand. 1978;57(3):257-9.

Tang Y, Zhu J, Zhou GX, Dai L, Wang YP, Liang J. [An epidemiological study on conjoined twins in China, from 1996 to 2004]. Zhonghua Yu Fang Yi Xue Za Zhi. 2007 Jun;41(Suppl):146-9.

Tannuri AC, Batatinha JA, Velhote MC, Tannuri U. Conjoined twins: twenty years' experience at a reference center in Brazil. Clinics (Sao Paulo). 2013;68(3):371-7.

Spencer R. Theoretical and analytical embryology of conjoined twins: part I: embryogenesis. Clin Anat. 2000;13(1):36-53.

Spencer R. Theoretical and analytical embryology of conjoined twins: part II: adjustments to union. Clin Anat. 2000;13(2):97-120.

Guttmacher AF. Biographical notes on some famous conjoined twins (Birth defects original article series). Natl Found. 1967;3:10-7.

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

McHugh K, Kiely EM, Spitz L. Imaging of conjoined twins. Pediatr Radiol. 2006 Sep;36(9):899-910;quiz 1002-3.

Agarwal U, Dahiya P, Khosla A. Vaginal birth of conjoined thoracopagus--a rare event. Arch Gynecol Obstet. 2003 Nov;269(1):66-7.

Shaw CC, Brumbaugh BB, Novey A. An anatomical and clinical study of a thoracopagus monster delivered alive at full time. Am J Obstet Gynaecol. 1934;27:655.

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Published

2016-12-24