Thoraco-Omphalopagus Conjoined Twins: Imaging and Antenatal Diagnosis
Journal Title: International Journal of Contemporary Medicine surgery and Radiology - Year 2017, Vol 2, Issue 4
Abstract
Introduction: Conjoined twins are a rare occurrence with a reported incidence of 1 per 33,000-165,000 births in developed countries. Since still birth rate amongst conjoined twins is 40- 60% the incidence becomes approximately 1 per 200,000 live births. Early diagnosis by ultrasound scan is very important as it provides the parents with an option of safe termination. An alternative would be MRI which will give better tissue contrast. Case Report: A 28-year-old G2P1 female had an antenatal ultrasound done for the first time at 16 weeks of gestation for assessment of fetal being and to know the gestational age. An ultrasound examination done by us showed two fetal heads at the same level and in the same plane. Both heads had a fixed relation with each other. The fetal chests and abdomen were found to be fused. Based upon ultrasound findings a diagnosis of thoraco-omphalopagus conjoint twins was made. Parents opted for medical termination of pregnancy hence MTP was done. An MRI was done before termination for confirmation of diagnosis, ruling out associated congenital anomalies and for academic purpose. MRI confirmed the ultrasound findings and ruled out presence of associated congenital anomalies. Conclusion: Conjoined twins are a very rare malformation seen exclusively in monoamniotic monochorionic twins. It can be suspected on antenatal ultrasound if in a twin pregnancy both fetal heads persistently maintain same level. Early antenatal diagnosis is essential to provide the parents with an option of safe termination.
Authors and Affiliations
Asmita Suryawanshi, Mohammed Shafi, Prasanna Mishrikotkar, D. B Dahiphale, Prashant Lathkar
Keywords
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