Journal of Human Anatomy (JHUA)
ISSN: 2578-5079
Case Report
Missed Early Diagnosis of Rare Case Thoraco-Omphalopagus
Conjoined Twins: Case Report
Abstract
Introduction: Conjoined twins are rare congenital anomaly with mortality and morbidity. It is result of a faulty division of an embryo at 13-15 days of conception. Thoraco-omphalopagus that was undiagnosed early and cancelling on the prognosis of the outcome and termination of pregnancy would have been done early leading to avoidance of cesarean section and neonatal morbidity and mortality.
Case Report: A 28-year-old para 3+0 G4 with twin gestation at 35/40 by a third trimester scan no other scan had been done. Before she was Unsure of her dates, also reported family history of twinning. Admitted to Kenyatta National Hospital as a referral from Nyahururu county hospital with a diagnosis of conjoined twins for specialized care. Obstetric ultrasound done revealed monochromic, monoamniotic viable Conjoined twins both flexed in breech. Twin A (34+4)/40 2289 grams, B 36/40 2368grams. BPP 8/8. Differential diagnosis of Thoraco-omphalopagus with shared and communicating heart and liver. Placenta fundo-posterior not low lying, with minimal infarctive areas.
Conclusion: The conjoined twins are rare and complex, majority of cases are stillbirth or die soon after birth but when there is early ultrasound an essential requirement for safe medical termination of pregnancy to avoid more complication and knowing that the rate of survival is very low. We need to understand that early ultrasound mostly in first trimester is very important. Attempt at surgery depends on the type of conjoined twins, the degree and type of organs shared by the twins, as in our case both they shared heart and liver.
Keywords: Monoamniotic-Monochorionic twins; Thoraco-omphalopagus; Antenatal diagnosis
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