Conjoined twins pregnancies: experience with 36 cases from a single center
M L Brizot1, A W Liao, L M Lopes
1Department of Obstetrics and Gynecology, São Paulo University Medical School, São Paulo, SP, Brazil. mlbrizot@uol.com.br
Prenatal Diagnosis
|September 10, 2011
Summary
Management of conjoined twins is complex, with surgical separation often not feasible. Early referral to specialized centers is crucial for accurate prognosis and planning of care for these rare twin pregnancies.
Area of Science:
- Perinatology
- Fetal Surgery
- Maternal-Fetal Medicine
Background:
- Conjoined twins are a rare complication of twin pregnancies.
- Management requires specialized multidisciplinary care.
- Prenatal diagnosis and assessment are critical for determining outcomes.
Purpose of the Study:
- To review a single tertiary center's experience in managing twin pregnancies complicated by conjoined fetuses.
- To analyze prenatal findings, delivery methods, surgical interventions, and perinatal outcomes.
- To evaluate the feasibility and success rates of surgical separation for conjoined twins.
Main Methods:
- Retrospective review of 36 twin pregnancies with conjoined fetuses over 12 years.
- Analysis of prenatal ultrasound and echocardiographic findings.
- Documentation of delivery details, surgical procedures, and survival rates.
Main Results:
- Thoracopagus twins were the most common type (69.4%).
- High incidence of cardiac defects (91.6%) and other malformations (61.8%).
- Surgical separation was deemed not feasible in 83.3% of cases, with an overall survival rate of 8.3%.
Conclusions:
- Conjoined twin pregnancies necessitate referral to tertiary centers for expert evaluation.
- Detailed fetal anomaly and echocardiographic assessments are vital for prognosis.
- Careful consideration of surgical separation feasibility is essential for optimal management.
