Conjoined twins: symptoms, causes, treatment, etc. & bull; hello healthy

Definition

What are conjoined twins?

Conjoined twins is a term used to describe a pair of twins born with their skin and internal organs joined together. The birth of conjoined twins occurs when the fetus (embryo) does not manage to separate completely.

Even though this embryo produces two fetuses, the two of them will still have a fused physique. Usually, conjoined twins are attached to the chest, abdomen, or pelvis. Several pairs of twins with this condition also have to share organs in their bodies.

Many cases of conjoined twins die before birth, or die some time after birth. However, there have also been cases where twins with this condition were successfully separated by surgical procedures.

The success rate of the operation depends on which part of the body the twins are connected to, how many and which part of the organ is split in half, as well as the ability of the operating team handling the baby.

How common are conjoined twins?

The birth of conjoined twins is an extremely rare condition. Conjoined twins occur only once in every 200,000 births. In addition, 70% of twins born with the connected body are female.

About 40-60 percent of conjoined twins die at birth and about 35 percent survive only 1 day. Only 5-25% of twins with this condition can survive until they grow up.

Signs & symptoms

What are the symptoms of conjoined twins?

Generally, there are no specific signs or symptoms that indicate a pregnant woman is carrying conjoined twins.

Similar to normal twin pregnancies, the size of the mother's uterus grows larger than pregnancies with one fetus. Pregnant women may also experience fatigue, nausea, and vomiting in early pregnancy. Twins with connected limbs can usually only be detected through ultrasound tests.

Depending on which part of the body is connected, babies born with conjoined twins are generally divided into several types as below:

1. Thoracopagus twins

Thoracopagus conjoined twins are born with a connected chest so that their faces face each other. Generally thoracopagus twins have one heart, one liver, and one intestine. This condition is one of the most common types.

2. omphalopagus twins

Omphalopagus twins are connected at the stomach, usually the umbilical cord. In most of these cases, the two babies share one liver and intestine. However, each has a separate functioning heart.

3. Pygopagus twins

This type of conjoined twins are connected on the back, which is at the bottom of the spine to the buttocks. Some pygophageal twins usually have one lower digestive tract. In other, rarer cases, both babies also only have one reproductive organ.

4. Rachipagus twins

The rachipagus or rachiopagus type connects right at the spine. This condition is among the rarest.

5. Ischiopagus twins

Twins of this type are connected at the pelvis. Usually, the two babies will be facing each other or attached to the sides of the body.

Most ischiopagus twins have one digestive tract, liver, and reproductive organs. Each baby may have two legs, or in rare cases, the baby will share three legs.

6. Parapagus twins

Parapagus twins are connected to the sides of the pelvis and part of the stomach and chest, but with separate heads. Both babies usually have two or four arms, and two or three legs.

7. Craniopagus twins

Craniopagus twins are connected in a back to back position, precisely above or beside the head. These twins share a portion of the skull, but usually both babies have their own brains.

8. Cephalopagus twins

Cephalopagus twins are connected to the face and upper body. Their faces face different directions, but usually they have a head and a brain that is connected. This type of conjoined twins rarely survive long.

When to go to the doctor

Most conjoined twins are very weak at birth, which explains why doctors have to watch their condition carefully and constantly.

Cause

What causes conjoined twins?

The birth of twins occurs when the fertilized egg divides and develops into two different fetuses. After 8 or 12 days the egg is fertilized, the lining of the embryo that will form the organs and body structure of the fetus.

Normally, the formation of these tissue structures occurs when the twin embryos have separated from each other. Unfortunately, in this case, the fetus will divide too late or separate even though the tissue formation process continues.

As a result, there are several fetal organs that are still connected to one another.

There is also another theory that suspects that connected twins are formed from two different embryos, which then fuse in early pregnancy.

Experts believe that this condition is caused by genetic factors. However, it is not yet known what the exact cause of the two phenomena above is.

Risk factors

What increases the risk of having conjoined twins?

Siamese twins have a genetic predisposition. This means if you have a family history of conjoined twins (a relative has twins with this condition), you may also be at risk of having twins with connected body parts.

Medicines & Medicines

The information described is not a substitute for medical advice. ALWAYS consult your doctor.

How do doctors diagnose conjoined twins?

Doctors can diagnose conjoined twin pregnancies in mothers by means of ultrasound tests (USG) and magnetic resonance imaging (MRI) in the first trimester.

Imaging tests accompanied by a more detailed echocardiogram test may be used in mid-gestational age. The goal is to determine what type and how the organs of the two prospective babies function.

If the parents of the prospective baby decide to continue the pregnancy, both babies must be delivered by caesarean section.

After delivery, the doctor will perform a series of imaging tests to find out what causes the baby to be connected, how each baby's organs function, and how to treat the twins.

How to deal with conjoined twins

Here are some treatments that can be done on conjoined twins:

1. Handling during pregnancy

Mothers carrying babies with this condition should receive special supervision during pregnancy. You may be referred to a gynecologist who specializes in managing high-risk pregnancies. You may also be treated by other specialists, such as a pediatric surgeon and a pediatric cardiologist.

2. The delivery process

The doctor will perform a caesarean section for the delivery process, which is done two to four weeks before the due date. After both babies are born, the doctor will do a thorough examination.

This examination aims to determine whether conjoined twins can be separated by surgical procedures or not.

3. Separation operation

Separation surgery cannot be performed on all babies born with this condition. The action depends on the type and which part of the body is connected.

When the internal organs are connected, it is very difficult for doctors to separate them. This can threaten one or both babies.

However, if the diagnosis shows that the two babies can be separated, and their family agrees to make this decision, the doctor will perform the separation surgery. Babies who are separated are expected to grow normally like other babies.

Home remedies

What are some lifestyle changes or home remedies that can treat conjoined twins?

Not all cases of conjoined twins can be resolved by separation surgery. Conjoined twins really need care from their family and health care providers.

If you or your relatives have twins with this condition, you should be trained by nurses, nutritionists, child life specialists, social workers, and so on. This will help you find the best solution for caring for both babies.

If you have questions, consult your doctor to better understand the best solution for you.

Hello Health Group does not provide health advice, diagnosis or treatment.