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Chapter 10 - Conjoined Twinning

Diagnosis and Management

Published online by Cambridge University Press:  11 October 2022

By
Alice King  and
Michael A. Belfort
Edited by
Leanne Bricker ,
Julian N. Robinson  and
Baskaran Thilaganathan
Leanne Bricker
Affiliation:
Corniche Hospital, Abu Dhabi
Julian N. Robinson
Affiliation:
Brigham & Women's Hospital, Boston
Baskaran Thilaganathan
Affiliation:
St George's Hospital Medical School, University of London
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Summary

Conjoined twins are a rare anomaly with a high rate of in-utero and perinatal mortality. They are physically joined in ventral, lateral or dorsal unions and may be detected early in prenatal care with ultrasound. The prognosis and ability to separate conjoined twins is specific to their anatomy. Extensive prenatal and postnatal evaluation with a combination of sonography, computed tomography, magnetic resonance imaging, echocardiography and fluoroscopy are used together in order to tailor a care plan for each patient. Conjoined twins are typically delivered as scheduled surgical deliveries,and may be managed postnatally with 1) non-operative management, 2) emergency separation, or 3) planned surgical separation.

Type
Chapter
Information
Management of Multiple Pregnancies
A Practical Guide
 , pp. 99 - 111
Publisher: Cambridge University Press
Print publication year: 2022

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References

Mian, A, Gabra, NI, Sharma, T, Topale, N, Gielecki, J, Tubbs, RS et al. Conjoined twins: from conception to separation, a review. Clin Anat N Y N 2017;30(3):385–96.Google Scholar
O’Brien, P, Nugent, M, Khalil, A. Prenatal diagnosis and obstetric management. Semin Pediatr Surg 2015 Oct;24(5):203–6.CrossRefGoogle ScholarPubMed
Pierro, A, Kiely, EM, Spitz, L. Classification and clinical evaluation. Semin Pediatr Surg 2015 Oct;24(5):207–11.CrossRefGoogle ScholarPubMed
Spencer, R. Anatomic description of conjoined twins: a plea for standardized terminology. J Pediatr Surg 1996 Jul;31(7):941–4.CrossRefGoogle ScholarPubMed
Pajkrt, E, Jauniaux, E. First-trimester diagnosis of conjoined twins. Prenat Diagn 2005 Sep;25(9):820–6.Google Scholar
Mehollin-Ray, AR. Prenatal and postnatal radiologic evaluation of conjoined twins. Semin Perinatol 2018;42(6):369–80.Google Scholar
Mackenzie, TC, Crombleholme, TM, Johnson, MP, Schnaufer, L, Flake, AW, Hedrick, HL et al. The natural history of prenatally diagnosed conjoined twins. J Pediatr Surg 2002 Mar;37(3):303–9.Google Scholar
Andrews, RE, Yates, RWM, Sullivan, ID. The management of conjoined twins: cardiology assessment. Semin Pediatr Surg 2015 Oct;24(5):217–20.Google Scholar
Harvey, DJ, Totonchi, A, Gosain, AK. Separation of craniopagus twins over the past 20 years: a systematic review of the variables that lead to successful separation. Plast Reconstr Surg 2016 Jul;138(1):190–200.Google Scholar
Fallon, SC, Olutoye, OO. The surgical principles of conjoined twin separation. Semin Perinatol 2018;42(6):386–92.Google Scholar
Yamada, NK, Fuerch, JH, Halamek, LP. Modification of the Neonatal Resuscitation Program Algorithm for Resuscitation of Conjoined Twins. Am J Perinatol 2016 Mar;33(4):420–4.Google Scholar
Parmekar, S, McMullen, L, Washington, C, Arnold, JL. Role of simulation in preparation for the care of conjoined twins: prenatal preparation to separation. Semin Perinatol 2018;42(6):329–39.Google Scholar

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