Sisay Woldeyes Wondimagegnehu
Assistant Professor of Obstetrics and Gynecology, Hawassa University, College of Medicine and Health Sciences, Ethiopia.
Case Rep Obstet Gynecol. 2018 Dec 5;2018:9319721. doi: 10.1155/2018/9319721. eCollection 2018.
Conjoined twin is a rare complication of monozygotic twins resulting from incomplete splitting of an embryo into two separate twins or early secondary fusion of two originally separated embryos. When diagnosed at early gestation, one can get adequate time to counsel the family on whether to continue with the pregnancy and proper intervention can be planned. On the other hand, undiagnosed cases may be first recognized in labor after they have caused labor-related complications. In the present case report, an undiagnosed case of a conjoined twin has presented in labor followed by delivery of one baby with the retention of the second baby. This presented a unique challenge to the managing team and required hysterotomy to effect delivery of the unborn baby. We report this case to highlight the importance of early diagnosis of a conjoined twin. On another hand where this does not happen and a conjoined twin is suspected for the first time after it has caused labor-related complications, the management should be individualized based on the clinical circumstance.
联体双胎是单卵双胎的一种罕见并发症，由胚胎不完全分裂为两个独立的胎儿或两个原本分离的胚胎早期二次融合所致。在妊娠早期诊断时，有足够的时间为家庭提供咨询，决定是否继续妊娠，并可制定适当的干预措施。另一方面，未被诊断出的病例可能在分娩时出现与分娩相关的并发症后才首次被发现。在本病例报告中，一名联体双胎未被诊断出的病例在分娩时出现，其中一个婴儿出生后，另一个婴儿仍未娩出。这给管理团队带来了独特的挑战，需要进行子宫切开术才能娩出未出生的婴儿。我们报告此病例以强调联体双胎早期诊断的重要性。另一方面，如果未早期诊断，联体双胎在引起与分娩相关的并发症后首次被怀疑时，应根据临床情况进行个体化管理。
