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Incidental Intraoperative Diagnosis of Term Conjoined Twins: A Case Series

JOURNAL OF NEPAL MEDICAL ASSOCIATION(2023)

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Abstract
Conjoined twins (Siamese twins) represent the rarest form of twin pregnancy. Reported here are two rare cases of conjoined term twins presented to the department of Obstetrics and Gynaecology within 3 months. The first case, 32 years of gravida 6 parity 5 referred from the periphery on 16 May 2022 after a full trial of labour following multi-organ dysfunction and term intrauterine dead twins. Intraoperatively it was dead conjoined thoraco-omphalopagus females. The patient died after 3 days following multiorgan dysfunction syndrome and disseminated intravascular coagulation. The second case, 22 years gravida 2 parity 1 also referred from periphery on 8 August 2022 in the second stage of labour with the diagnosis of 39 weeks intrauterine dead twins with obstructed labour, delivered by caesarean with intraoperative conjoined dead females of thoracophagus type. Twins is itself a high -risk pregnancy and this rare diagnosis with complications could have been prevented by regular antenatal checkups, ultrasonography performed by radiologists and early referral antenatally in labour along with a multidisciplinary approach.
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Key words
conjoined,monozygotic twinning,siamese twins,twins
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