Diagnostic Dialema for Dicephalic Parapagus Conjoined Twins- A Case Report.
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2017, Vol 2, Issue 6
Abstract
A 26 years old pregnant women gravida 3 Para 2 live2 reported in casualty of B.S.A hospital DELHI India as term pregnancy with arrest of after coming head of breech. . At the time of presentation to hospital pt was dehydrated and uterus was 28-30 wks size, moderate contraction was present uterine contour maintained, cyanosed lower limb, genitals trunk and anterior shoulder of baby was out of vagina and posterior shoulder was high and baby was dead . Examination finding gave the clue for arrest of hydrocephalic head of breech baby but patient antenatal record was contradictory to this finding She was booked at primary health centre, where she was fully investigated and immunised and USG done at this centre at 28 weeks showed twin pregnancy with both twins in breech presentation and single posterior placenta .To clarify this diagnostic dilemma X ray lower abdomen with pelvis AP view was taken. Which showed baby were dicephalic parapagus conjoined twins two heads, two cervical, thoracic and lumbar spine with fusion at sacral region, whose both head arrested during breech vaginal delivery. This case taught us that antenatal check up and good quality USG at early gestation is essential for better maternal and foetal outcome .When there is any doubt about the diagnosis of twins pregnancy in USG especially in monoamniotic twins repeated USG to be done by expert radiologist so that diagnosis of conjoint twins should not be missed and further management can be done properly.
Authors and Affiliations
Dr. Leena Bhatnagar
Keywords
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