title: Conjoined twins: From conception to separation, a review.
abstract: Conjoined twins are suggested to result from aberrant embryogenesis. The two main theories proposed to explain the phenomena are fission and fusion. The incidence rate is 1 in 50,000 births; however, since about 60% of the cases are stillborn, the true incidence is approximated at 1 in 200,000. There is a higher predisposition towards female than male gender with a ratio of 3:1. Conjoined twins are classified based upon the site of attachment. The extent of organ sharing, especially the heart, determines the possibility and prognosis of a separation procedure. Meticulous preoperative evaluation, planning, and preparedness of the team are crucial for a successful separation. Separation of conjoined twins poses several technical, legal, and ethical issues. Clin. Anat. 30:385-396, 2017. © 2017 Wiley Periodicals, Inc.
authors.affiliation: Department of Anatomical Sciences, School of Medicine, St. George's University, Grenada, West Indies.
authors.forename: Asma
authors.initials: A
authors.lastname: Mian
authors.affiliation: Department of Anatomical Sciences, School of Medicine, St. George's University, Grenada, West Indies.
authors.forename: Nader Ishak
authors.initials: NI
authors.lastname: Gabra
authors.affiliation: Department of Anatomical Sciences, School of Medicine, St. George's University, Grenada, West Indies.
authors.forename: Tanuj
authors.initials: T
authors.lastname: Sharma
authors.affiliation: Department of Anatomical Sciences, School of Medicine, St. George's University, Grenada, West Indies.
authors.forename: Nitsa
authors.initials: N
authors.lastname: Topale
authors.affiliation: Department of Anatomy, Faculty of Medicine, University of Warmia and Mazury in Olsztyn, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Gielecki
authors.affiliation: Seattle Science Foundation, Seattle, Washington.
authors.forename: R Shane
authors.initials: RS
authors.lastname: Tubbs
authors.affiliation: Department of Anatomical Sciences, School of Medicine, St. George's University, Grenada, West Indies.
authors.forename: Marios
authors.identifier: 0000-0003-2811-6657
authors.initials: M
authors.lastname: Loukas
mesh_terms: D026688:Bioethical Issues; D005260:Female; D049668:History, 15th Century; D049670:History, 17th Century; D049671:History, 18th Century; D049672:History, 19th Century; D049673:History, 20th Century; D049690:History, Ancient; D049691:History, Medieval; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008488:Medical Illustration; D011247:Pregnancy; D017678:Sex Distribution; D014428:Twins, Conjoined / Q000145:classification / Q000196:embryology / Q000601:surgery; D016216:Ultrasonography, Prenatal / Q000379:methods
keywords: Siamese twins; cephalopagus; craniopagus; embryogenesis; ischiopagus; omphalopagus; parapagus; pygopagus; rachipagus; thoracopagus