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DOI: 10.1055/s-0041-1739297
Antenatal Diagnosis of Parapagus Conjoined Twins: 3D Virtual and 3D Physical Models
Diagnóstico antenatal de gêmeos unidos parapagus: Modelos 3D virtuais e físicosAbstract
Conjoined twins (CTs) are a rare complication from monochorionic and monoamniotic twin pregnancies. We describe the use of 3D technologies, including 3D virtual and 3D physical models on prenatal evaluation of one parapagus CT. A 16-year-old G1P0 woman was referred for fetal magnetic resonance imaging (MRI) anatomical evaluation of a CT at 28 weeks of gestation. 3D images of the fetal surface were generated by the software during the examination for spatial comprehension of the relationship between the fetal parts. The pair of CTs died at the 32nd week of gestation, a few hours after cesarean section. 3D technologies are an important tool for parental counseling and preparation of the multidisciplinary care team for delivery and neonatal assistance and possible surgical planning for postnatal separation in CTs cases.
Resumo
Gêmeos unidos (GUs) são uma complicação rara de gestações gemelares monocoriônicas e monoamnióticas. Descrevemos o uso de tecnologias 3D, incluindo modelos 3D virtuais e físicos, na avaliação pré-natal de GU parapagus. Mulher de 16 anos, G1P0, foi encaminhada para avaliação anatômica por ressonância magnética (RM) fetal de GU com 28 semanas de gestação. Imagens 3D da superfície fetal foram geradas pelo software durante o exame para compreensão espacial da relação entre as partes fetais. O par de GUs morreu na 32ª semana de gestação, poucas horas após a cesariana. As tecnologias 3D são uma importante ferramenta de aconselhamento dos pais e de preparação da equipe multiprofissional para o parto e a assistência neonatal, além de possível planejamento cirúrgico para separação pós-natal em casos de GUs.
Publikationsverlauf
Eingereicht: 29. November 2020
Angenommen: 04. Oktober 2021
Artikel online veröffentlicht:
21. Dezember 2021
© 2021. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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References
- 1 Mian A, Gabra NI, Sharma T, Topale N, Gielecki J, Tubbs RS. et al. Conjoined twins: From conception to separation, a review. Clin Anat 2017; 30 (03) 385-396 DOI: 10.1002/ca.22839.
- 2 Frawley G. Conjoined twins in 2020 - state of the art and future directions. Curr Opin Anaesthesiol 2020; 33 (03) 381-387 DOI: 10.1097/ACO.0000000000000864.
- 3 Teixeira Castro P, Werner H, Matos AP, Daltro P, Araujo Júnior E. Symmetric and ventrally conjoined twins: prenatal evaluation by ultrasound and magnetic resonance imaging and postnatal outcomes. J Matern Fetal Neonatal Med 2021; 34 (12) 1955-1962 DOI: 10.1080/14767058.2019.1651282.
- 4 Mutchinick OM, Luna-Muñoz L, Amar E, Bakker MK, Clementi M, Cocchi G. et al. Conjoined twins: a worldwide collaborative epidemiological study of the International Clearinghouse for Birth Defects Surveillance and Research. Am J Med Genet C Semin Med Genet 2011; 157C (04) 274-287 DOI: 10.1002/ajmg.c.30321.
- 5 Spencer R. Anatomic description of conjoined twins: a plea for standardized terminology. J Pediatr Surg 1996; 31 (07) 941-944 DOI: 10.1016/s0022-3468(96)90417-0.
- 6 Tannuri AC, Batatinha JA, Velhote MC, Tannuri U. Conjoined twins: twenty years' experience at a reference center in Brazil. Clinics (São Paulo) 2013; 68 (03) 371-377 DOI: 10.6061/clinics/2013(03)oa14.
- 7 Willobee BA, Mulder M, Perez EA, Hogan AR, Brady A-C, Sola JE, Thorson CM. et al. Predictors of in-hospital mortality in newborn conjoined twins. Surgery 2019; 166 (05) 854-860 DOI: 10.1016/j.surg.2019.06.028.
- 8 Goldman-Yassen AE, Goodrich JT, Miller TS, Farinhas JM. Preoperative evaluation of craniopagus twins: anatomy, imaging techniques, and surgical management. AJNR Am J Neuroradiol 2020; 41 (06) 951-959 DOI: 10.3174/ajnr.A6571.
- 9 Wood BC, Sher SR, Mitchell BJ, Oh AK, Rogers GF, Boyajian MJ. Conjoined twin separation: integration of three-dimensional modeling for optimization of surgical planning. J Craniofac Surg 2017; 28 (01) 4-10 DOI: 10.1097/SCS.0000000000003412.
- 10 Norwitz ER, Hoyte LP, Jenkins KJ, van der Velde ME, Ratiu P, Rodriguez-Thompson D. et al. Separation of conjoined twins with the twin reversed-arterial-perfusion sequence after prenatal planning with three-dimensional modeling. N Engl J Med 2000; 343 (06) 399-402 DOI: 10.1056/NEJM200008103430604.
- 11 Mathew RP, Francis S, Basti RS, Suresh HB, Rajarathnam A, Cunha PD. et al. Conjoined twins - role of imaging and recent advances. J Ultrason 2017; 17 (71) 259-266 DOI: 10.15557/JoU.2017.0038.
- 12 Swift DM, Weprin B, Sklar F, Sacco D, Salyer K, Genecov D, Barcello R. et al. Total vertex craniopagus with crossed venous drainage: case report of successful surgical separation. Childs Nerv Syst 2004; 20 (8-9): 607-617 DOI: 10.1007/s00381-004-1011-6.
- 13 Heuer GG, Madsen PJ, Flanders TM, Kennedy BC, Storm PB, Taylor JA. Separation of craniopagus twins by a multidisciplinary team. N Engl J Med 2019; 380 (04) 358-364 DOI: 10.1056/NEJMoa1805132.
- 14 Mehollin-Ray AR. Prenatal and postnatal radiologic evaluation of conjoined twins. Semin Perinatol 2018; 42 (06) 369-380 DOI: 10.1053/j.semperi.2018.07.015.