Hernández-Valencia M, Baruch Pavón Rojas A, Ferrer Ponce L A, Alvarez Muñoz M
Servicio de Ginecología y Obstetricia, Hospital General Dr. José Ma. Rodríguez, ISEM-SSA, Ecatepec, Estado de México, México.
Ginecol Obstet Mex. 1998 Dec;66:499-502.
Cojoined twins was analyzed type cephalothoracoabdominopagus, is especially rare case of dysgenetic abnormalities, in which the heads, necs, thoraces and abdomen are joined. Twins births joined have been said to occur with a frequency of 1 per 100,000 deliveries, but the incidence of this malformations is one in three million conjoined twins. Conjoined twinning may be associated with a more fundamental failure of embryonic migration or may be associated with a more fundamental failure of ambryonic migration or fusion, 95% of conjoined twins are females. The Janiceps type of cephalothoracoabdominopagus derives its name from Janus, in Roman nythology, the god of doors and gateways, his statue with two faces, facing east and west for the beginning and ending of the day. The anatomic features with the Janiceps type of cephalothoracoabdominopagus are describe, and the mechanisms that may have played a role in the abnormal development of these twins are discussed. The mother was a 22-year-old, with last menstrual period January 12, 1997. She came to the other medical center, with an ultrasound study performed at 27 weeks' gestation, and possible multiple fetal anormalies, a second ultrasound examination, confirmed abnormalities, two hearts, as well as polihidramnios. Past history included normal espontaneous vaginal delivery of healthy term infant, who were alive and well, family history was negative for congenital anormalies, and no prior history of twinning. She denied use of drugs, alcohol, or cigarettes; had no fever, vaginal bleeding, or other problems with the pregnancy. The abdomen was gravid to 48 cm, and contractions were palpable, fetal heart tones were 1400 beats per minute. On the one day of admission the patient underwent delivery of conjoined infants, the Apgar scores were zero at 1 minute and at 5 minutes. The infants were joined front-to-front, with two faces, each a compositive of toth twins, each twin han four extremities, in each face resambled a one nose, with structure incomplete in one face, esophagi were fused. Each twin had its own skeletal system extending from the cervical spine downwards. The congenital malformations for each conjoined twin are listed in the autopsy report, abnormalities included absent ovary and uterus in both twin. COnjoined twins develop from a single zygote, the cause is unknown. We proposed, embryonic tissue divides incompletely, likely to result in twinning anomalies from the 15th to 16th day postovulation, during the late part of period six, about the third week.
联体双胎被分析为头胸腹联体类型，是发育异常中极为罕见的病例，其中头部、颈部、胸部和腹部相连。联体双胎的出生据说每10万次分娩中发生1例，但这种畸形在联体双胎中的发生率为三百万分之一。联体双胎可能与胚胎迁移的更根本失败有关，或者可能与胚胎迁移或融合的更根本失败有关，95%的联体双胎是女性。头胸腹联体的雅努斯头型得名于罗马神话中的雅努斯，他是掌管门户的神，其雕像有两张脸，分别面向东西，象征一天的开始和结束。描述了头胸腹联体雅努斯头型的解剖特征，并讨论了可能在这些双胎异常发育中起作用的机制。母亲22岁，末次月经日期为1997年1月12日。她前往另一家医疗中心，在妊娠27周时进行了超声检查，发现可能存在多胎异常，第二次超声检查证实了异常情况，有两个心脏以及羊水过多。既往史包括足月顺产一名健康婴儿，该婴儿健在且状况良好，家族史中无先天性异常，也没有双胎妊娠史。她否认使用过药物、酒精或香烟；孕期无发热、阴道出血或其他问题。腹部隆起至48厘米，可触及宫缩，胎儿心率为每分钟140次。入院当天，患者产下联体婴儿，1分钟和5分钟时阿氏评分均为零。婴儿面对面相连，有两张脸，每张脸由两个双胞胎的部分组成，每个双胞胎有四条肢体，每张脸有一个鼻子，其中一张脸的结构不完整，食管融合。每个双胞胎都有自己从颈椎向下延伸的骨骼系统。尸检报告列出了每个联体双胎的先天性畸形，异常情况包括两个双胞胎均无卵巢和子宫。联体双胎由单个受精卵发育而来，原因不明。我们推测，胚胎组织未完全分裂，很可能在排卵后第15至16天，即第六阶段后期，大约第三周时导致双胎异常。
