Conjoined twins: experience in an Irish tertiary centre

Area of Science:

• Perinatology
• Maternal-Fetal Medicine
• Congenital Anomalies

Background:

• Conjoined twins are a rare pregnancy complication with an incidence of 0.19 per 10,000 pregnancies in Europe.
• This case series examines four spontaneous conjoined twin pregnancies managed at a tertiary referral center between 2005 and 2011.

Observation:

• Cases were diagnosed via antenatal ultrasound and monitored by a multidisciplinary team using serial imaging (ultrasound, MRI, fetal echocardiography) and specialist referrals.
• Three female conjoined twin pairs were deemed non-surgically separable and received palliative care post-birth.
• One male conjoined twin pair underwent successful surgical separation at 4 months of age.

Findings:

• The local incidence of conjoined twins was approximately 0.63 per 10,000 over an 8-year period.
• A notable observation was the geographical proximity of the parents of the four cases, suggesting a potential localized cluster.
• Management strategies were tailored based on antenatal assessments of surgical separability.

Implications:

• This case series underscores the importance of multidisciplinary management for conjoined twins.
• The potential cluster warrants further investigation into etiological factors.
• Effective antenatal diagnosis and planning are crucial for optimizing outcomes in conjoined twin pregnancies.