Diptee Poudel1, Suraj Shrestha1, Roshan Aryal2, Ashmita Adhikari3, Sunita Bajracharya3. 1. Maharajgunj Medical Campus, Institute of Medicine, Maharajgunj, Nepal. 2. Maharajgunj Medical Campus, Institute of Medicine, Maharajgunj, Nepal. Electronic address: roshanaryal7@gmail.com. 3. Department of Obstetrics and Gynecology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
Abstract
INTRODUCTION AND IMPORTANCE: Conjoined twins represent a rare phenomenon and the etiology has not been clarified yet. There is a high rate of stillbirth and neonatal deaths resulting in very few cases surviving long enough for surgical separation. CASE PRESENTATION: A 33-year-old gravida 2 para 1 mother without any first and second trimester antenatal care visits was diagnosed to have conjoined twins in the third trimester. Mother and her family chose to terminate the pregnancy for which elective lower section cesarean section was done with the delivery of female conjoined twins, both of them subsequently declared dead within 4 h of birth. CLINICAL DISCUSSION: A conjoined twin gestation provides inimitable intricacy for obstetric management irrespective of the patient's areas of care. Early diagnosis through ultrasonography can be done and detailed evaluation is necessary along with fetal echocardiography regardless of site of fusion. Cesarean section is the recommended mode of delivery as this reduces various complications. CONCLUSION: The obstetricians' role in timely prenatal diagnosis, counseling, and organization of interdisciplinary medical care is indispensable in cases of conjoined twins.
INTRODUCTION AND IMPORTANCE: Conjoined twins represent a rare phenomenon and the etiology has not been clarified yet. There is a high rate of stillbirth and neonatal deaths resulting in very few cases surviving long enough for surgical separation. CASE PRESENTATION: A 33-year-old gravida 2 para 1 mother without any first and second trimester antenatal care visits was diagnosed to have conjoined twins in the third trimester. Mother and her family chose to terminate the pregnancy for which elective lower section cesarean section was done with the delivery of female conjoined twins, both of them subsequently declared dead within 4 h of birth. CLINICAL DISCUSSION: A conjoined twin gestation provides inimitable intricacy for obstetric management irrespective of the patient's areas of care. Early diagnosis through ultrasonography can be done and detailed evaluation is necessary along with fetal echocardiography regardless of site of fusion. Cesarean section is the recommended mode of delivery as this reduces various complications. CONCLUSION: The obstetricians' role in timely prenatal diagnosis, counseling, and organization of interdisciplinary medical care is indispensable in cases of conjoined twins.
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