Mathew Rishi Philip, Francis Swati, Basti Ram Shenoy, Suresh Hadihally B, Rajarathnam Annie, Cunha Prema D, Rao Sujaya V
Department of Radio-Diagnosis, Father Muller Medical College, Mangalore 575002, Karnataka, India.
Department of Obstetrics & Gynaecology, Yenepoya Medical College, Deralakatte 575018, Karnataka, India.
J Ultrason. 2017 Dec;17(71):259-266. doi: 10.15557/JoU.2017.0038. Epub 2017 Dec 29.
Conjoined twins are identical twins with fused bodies, joined in utero. They are rare complications of monochorionic twinning. The purpose of this study is to describe the various types of conjoined twins, the role of imaging and recent advances aiding in their management.
This was a twin institutional study involving 3 cases of conjoined twins diagnosed over a period of 6 years from 2010 to 2015. All the 3 cases were identified antenatally by ultrasound. Only one case was further evaluated by MRI.
Three cases of conjoined twins (cephalopagus, thoracopagus and omphalopagus) were accurately diagnosed on antenatal ultrasound. After detailed counseling of the parents and obtaining written consent, all the three cases of pregnancy were terminated. Delivery of the viable conjoined twins was achieved without any complications to the mothers, and all the three conjoined twins died after a few minutes.
Ultrasound enables an early and accurate diagnosis of conjoined twins, which is vital for obstetric management. MRI is reserved for better tissue characterization. Termination of pregnancy when opted, should be done at an early stage as later stages are fraught with problems. Recent advances, such as 3D printing, may aid in surgical pre-planning, thereby enabling successful surgical separation of conjoined twins.
联体双胎是在子宫内身体相连的同卵双胞胎。它们是单绒毛膜双胎妊娠的罕见并发症。本研究的目的是描述联体双胎的各种类型、影像学检查的作用以及有助于其治疗的最新进展。
这是一项双机构研究，纳入了2010年至2015年6年间诊断的3例联体双胎病例。所有3例均在产前通过超声确诊。仅1例进一步接受了磁共振成像（MRI）评估。
3例联体双胎（头部联体、胸部联体和腹部联体）在产前超声检查中得到准确诊断。在对父母进行详细咨询并获得书面同意后，所有3例妊娠均被终止。联体双胎顺利娩出，母亲未出现任何并发症，所有3例联体双胎在几分钟后死亡。
超声能够早期准确诊断联体双胎，这对产科管理至关重要。MRI用于更好地进行组织特征分析。若选择终止妊娠，应尽早进行，因为后期会充满问题。诸如3D打印等最新进展可能有助于手术预规划，从而实现联体双胎的成功手术分离。
