Conjoined twins @15+4 weeks

Purpose: Conjoined twins is a rare phenomenon, the occurrence is estimated to range from 1 in 50,000 births to 1 in 200,000 births. Approximately 40% are stillborn, the overall survival rate is about 20%. The condition is more frequently found among females, with a ratio of 3:1. The most famous pair of conjoined twins was Chang and Eng Bunker (1811 – 1874),Thai brothers born in Siam. As a crowd puller in a circus they were billed as the famous Siamese Twins for many years. Hence the term “Siamese twins” came to be used as a synonym for conjoined twins.

Material and methods: Case report and literature review.

Results: A 30-year-old gravida 3, para 2 presented for her first antenatal visit at at 15+4 weeks of gestation. Ultrasound showed a non-viable monochorial monoamniote twin pregnancy with the signs of a hydrops fetalis. Further a polyhydramnion was present. The fetuses were not distinguished from one another at the thoracic-abdominal level.

Ultrasound imaging was limited due to advanced state of fetale maceration. (Fig1 – 3).

Autopsy findings after induced abortion: the two femal bodies fused at the lower chest, only sharing the liver with a conjoined umbilical cord, no further organ system was involved (Fig4).

Fig. 1

Conclusion: Although the advanced state of fetal maceration limited ultrasound its results were still consistent with autopsy.