title: Conjoined twins and legal authorization for abortion.
abstract: OBJECTIVE
  To describe pregnancies with conjoined twins according to the request for legal termination of pregnancy.
  
  
  METHODS
  Retrospective review of pregnancies with conjoined twins, with no possibility of extrauterine survival or postnatal surgical separation, observed at a tertiary teaching hospital, between 1998 and 2010.
  
  
  RESULTS
  Amongst 30 cases seen during the study period, six (20.0%) couples decided to continue with the pregnancy, termination of pregnancy was not requested due to advanced gestational age (> 25 weeks) in 5 cases (16.7%). Legal authorization to terminate the pregnancy was requested in 19 (63.3%) cases: permission was granted in 12 (63.2%), denied in five (26.3%) and information was missing in two (10.5%) cases. A successful vaginal delivery was performed in 83.3% of the cases undergoing termination of pregnancy and a cesarean section was performed in all the remaining cases (p < 0.01).
  
  
  CONCLUSIONS
  In pregnancies with conjoined twins and without fetal prognosis, legal termination of the pregnancy is an alternative. Moreover, a successful vaginal delivery can be performed in most cases before the third trimester, further reducing maternal risks and parental suffering.
authors.affiliation: Department of Obstetrics and Gynecology of Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil. roseli.nomura@hotmail.com
authors.forename: Roseli Mieko Yamamoto
authors.initials: RM
authors.lastname: Nomura
authors.forename: Maria de Lourdes
authors.initials: Mde L
authors.lastname: Brizot
authors.forename: Adolfo Wenjaw
authors.initials: AW
authors.lastname: Liao
authors.forename: Wagner Rodrigues
authors.initials: WR
authors.lastname: Hernandez
authors.forename: Marcelo
authors.initials: M
authors.lastname: Zugaib
mesh_terms: D000029:Abortion, Legal / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D000032:Abortion, Therapeutic / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D000328:Adult; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications; D012189:Retrospective Studies; D014428:Twins, Conjoined; D016216:Ultrasonography, Prenatal