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Parapagus dicephalus dipus tribrachius conjoined twins: a case report
Mwaba Kopa1, Lukundo Siame2, Michelo Haluuma Miyoba3,4
1Livingstone University Teaching Hospital, Department of Pediatrics, Livingstone, Zambia.
The Pan African Medical Journal
|June 26, 2025
Summary
Conjoined twins, a rare pregnancy complication, require early prenatal diagnosis. This case highlights the critical need for routine early anomaly scans to improve outcomes for these rare births.
Area of Science:
- Perinatology
- Maternal-Fetal Medicine
- Congenital Anomalies
Background:
- Conjoined twins result from incomplete embryonic splitting in monochorionic monoamniotic pregnancies around 13-14 days post-fertilization.
- Affecting approximately 1.47 per 100,000 live births, conjoined twins present significant management challenges.
Observation:
- A 17-year-old primigravida presented in the third trimester with ultrasound-diagnosed parapagus dicephalus dipus tribrachius conjoined twins.
- Delivery via elective cesarean section revealed twins sharing a single heart with complex cardiac anomalies including a three-ventricle system, atrial septal defect, and an incompetent atrioventricular valve.
Findings:
- The conjoined twins, despite surgical intervention, succumbed to sepsis on day 20 post-delivery.
- The case underscores diagnostic limitations in settings where routine second-trimester anomaly scans are not performed.
Implications:
- Routine early anomaly scans in pregnancy are essential for timely diagnosis and intervention in cases of conjoined twins.
- Improved prenatal detection facilitates crucial counseling and planning for multidisciplinary care, potentially improving outcomes for rare congenital anomalies.
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