Conjoined twins historically known as Siamese twins incidence is reported to be 1 in 50000 births. However, its’ true incidence is claimed to be around 1 in 200000 since about 60% of cases are prenatally diagnosed and terminated. We present a prenatal diagnosis of a rare case of conjoined twins, cephalothoracopagus diagnosed at 13th week of gestation. A 22-year-old, primigravid patient was referred to outpatient obstetrics clinic at 13th week of gestation with lethargy and nausea symptoms. 2-D abdominal ultrasound revealed an abnormal thickness on the neck region and hyperextension of the head was one of the first signs that got attention. Rigorous examination with VolusonE6 revealed one cranium, one heart, one umbilical cord, and 4 upper and 4 lower extremities confirming the diagnosis of conjoined twins. There was one cranium and the twins were ventrally conjoined at lower levels. Starting from the cranium there were 2 vertebral colons. Thorax and abdominal wall were conjoined. The twins shared one heart which supplied for both circulations. There was one stomach; liver and intestines were shared and there was one umbilical cord. The patient was informed; pregnancy termination following amniocentesis was offered. The patient refused amniocentesis and was referred to the perinatology clinic at 16th week of gestation accepting pregnancy termination. Postmortem examination of the fetuses confirmed the diagnosis of craniothoracopagus. In conclusion, early prenatal diagnosis of cephalo-thoracopagus is important since the complications can increase maternal morbidity and mortality. Patients should be counseled about prenatal prognosis, management, and termination options to avoid unnecessary surgical interventions and prevent complications.
Anahtar Kelimeler: Conjoined Twins, Prenatal Diagnosis, First Trimester
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