Nega Wassihun, Damte Meku, Girma Yonas, Desta Getachew, Hailemariam Mengistu
Department of Obstetrics and Gynecology, Bahir Dar University, Bahir Dar, Ethiopia.
Department of Surgery, Bahir Dar University, Bahir Dar, Ethiopia.
J Med Case Rep. 2016 Dec 1;10(1):340. doi: 10.1186/s13256-016-1023-3.
Craniopagus parasiticus is rare with an incidence of approximately four to six cases in 10,000,000 births. In our case, the head of the parasitic twin protruded from the temporal area of the normal twin's cranium. The parasitic twin had two deformed lower limbs, of which one was rudimentary, and long bones of the bilateral lower limbs and some pelvic bone. Dissection of the mass of the parasitic twin's body revealed the intestine but no chest organs or abdominal organs. There was a rudimentary labium but no vaginal opening. In resource-limited countries, maternal age or nutritional factors may play a role in craniopagus parasiticus.
A 38-year-old multigravida (gravida V para IV) woman of Amhara ethnicity was referred from a rural health center to our hospital due to prolonged second stage of labor at 42+1 weeks. On her arrival at our hospital, an obstetrician decided to do a caesarean section because she was unable to deliver vaginally. A live baby girl weighing 4200 g was delivered. The placenta was single and normal. Her Appearance, Pulse, Grimace, Activity, and Respiration scores were 7 and 9 at 1 and 5 minutes, respectively. She appeared to be grossly normal except for the parasitic co-twin attached to her cranium. After a week of extensive counselling and investigation, a successful separation operation was done. Postoperation, she comfortably suckled on the breast and had no neurological deficit. Two weeks after separation she was discharged in a good healthy condition with an arrangement for postnatal follow up.
The causes of craniopagus parasiticus are still unknown due to a rarity of cases and a limited number of studies on it. There have been only nine to ten cases of craniopagus parasiticus, of which only three survived past birth and were documented in the literature. Genetic scientists and researchers continue to investigate this case because they might find explanations for the birth defect, and provide answers to improve the prognosis and the life chances of twins with craniopagus parasiticus.
寄生性联体双胎极为罕见，在每1000万例出生中发生率约为4至6例。在我们的病例中，寄生双胎的头部从正常双胎颅骨的颞部突出。寄生双胎有两条畸形下肢，其中一条发育不全，还有双侧下肢的长骨和部分骨盆骨。对寄生双胎身体肿块进行解剖后发现了肠道，但没有胸部器官或腹部器官。有一个发育不全的阴唇，但没有阴道口。在资源有限的国家，产妇年龄或营养因素可能在寄生性联体双胎的发生中起作用。
一名38岁、孕5产4的阿姆哈拉族多产妇，因42 + 1周产程延长从农村卫生中心转诊至我院。她入院时，产科医生决定进行剖宫产，因为她无法经阴道分娩。一名体重4200克的活女婴出生。胎盘单一且正常。她在出生后1分钟和5分钟时的外貌、脉搏、 grimace（皱眉动作，此处可能是指评估新生儿反应的一项指标）、活动和呼吸评分分别为7分和9分。除了附着在她颅骨上的寄生联体双胎外，她看起来大体正常。经过一周的广泛咨询和检查后，成功进行了分离手术。术后，她能舒适地吸吮母乳，且没有神经功能缺损。分离两周后，她健康状况良好出院，并安排了产后随访。
由于病例罕见且相关研究数量有限，寄生性联体双胎的病因仍然不明。寄生性联体双胎仅有九至十例，其中只有三例出生后存活并被文献记载。基因科学家和研究人员继续对该病例进行研究，因为他们可能会找到这种出生缺陷的解释，并为改善寄生性联体双胎的预后及生存几率提供答案。
