title: Classification and clinical evaluation.
abstract: Conjoined twins represent a great challenge for most pediatric specialists including pediatric surgeons, anesthetists, neonatologists, urologists, neurosurgeons, and orthopedic surgeons. This anomaly can be classified according to the type of twins׳ fusion. Various organs can be fused making the separation difficult. Conjoined twins are usually diagnosed antenatally by ultrasound. Detailed fetal echocardiography is necessary to counsel the parents during pregnancy. Postnatally, the majority of the conjoined twins can be thoroughly investigated using various imaging techniques. This allows careful planning of the operation. However, in approximately one-third of the patients an urgent operation is required at birth without a complete assessment of the joining. This is associated with a poorer outcome.
authors.affiliation: Division of general and thoracic Surgery, The Hospital for Sick Children, 1526-555 University Ave, Toronto, Ontario, Canada M5G 1X8. Electronic address: agostino.pierro@sickkids.ca.
authors.forename: Agostino
authors.initials: A
authors.lastname: Pierro
authors.affiliation: Hospital for Children NHS Trust Great Ormond Street, London, England, UK.
authors.forename: Edward M
authors.initials: EM
authors.lastname: Kiely
authors.affiliation: Ex-Great Ormond Street Hospital & Institute of Child Health, London, England, UK.
authors.forename: Lewis
authors.initials: L
authors.lastname: Spitz
mesh_terms: D005260:Female; D006801:Humans; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D014428:Twins, Conjoined / Q000145:classification* / Q000601:surgery*
keywords: Conjoined twins; Neonatal surgery; Twins