title: Two cases of pregnancy involving conjoined twins, with details of management after opting for live birth.
abstract: Conjoined twinning is a unique complication of monochorionic pregnancy. This report describes the clinical findings in two cases of conjoined twins, and discusses their management. One case involved thoracopagus complicating a triplet pregnancy, and the other involved cephalothoracopagus, in which the outcome was intrauterine fetal death due to abruptio placentae after amniocentesis. Recent improvements in ultrasound imaging have facilitated the diagnosis of conjoined twins as early as the first trimester. Although many mothers opt to terminate pregnancy when conjoined twins are diagnosed, a few do not, as in the cases described. In such cases, pregnancy management, including accurate determination of the degree of organ fusion and psychological follow up, are important. On the basis of the two present cases, we present a systematic flow diagram for management of conjoined twin pregnancy from the time of diagnosis until delivery.
authors.affiliation: Department of Obstetrics and Gynecology, St. Marianna University, School of Medicine, Miyamae, Kawasaki, Kanagawa, Japan. s2takae@marianna-u.ac.jp
authors.forename: Seido
authors.initials: S
authors.lastname: Takae
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Izuchi
authors.forename: Kimie
authors.initials: K
authors.lastname: Murayama
authors.forename: Haruhiro
authors.initials: H
authors.lastname: Kondo
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Bunpei
authors.initials: B
authors.lastname: Ishizuka
mesh_terms: D005260:Female; D005313:Fetal Death; D005500:Follow-Up Studies; D006801:Humans; D011247:Pregnancy; D059286:Pregnancy, Triplet; D059285:Pregnancy, Twin; D014428:Twins, Conjoined; D016216:Ultrasonography, Prenatal