World Journal of Anemia

Register      Login

VOLUME 2 , ISSUE 1 ( January-March, 2018 ) > List of Articles


Ischiopagus Conjoined Twins delivered Vaginally

Mohita Agrawal, Rachna Agrawal

Keywords : Conjoint twins, Episiotomy, Ischiopagus

Citation Information : Agrawal M, Agrawal R. Ischiopagus Conjoined Twins delivered Vaginally. World J Anemia 2018; 2 (1):31-33.

DOI: 10.5005/jp-journals-10065-0025

License: CC BY-ND 3.0

Published Online: 01-12-2018

Copyright Statement:  Copyright © 2018; The Author(s).


Conjoint twins (CTs) are a very rare entity since it occurs only once in 50,000 to 2 lakh births. Female:male CTs are 3:1. Conjoint twins are monozygotic twins. In this sense, they share the same zygote where the twinning is initiated after 12 days of fertilization of egg. It may be due to genetic or environmental factors; 40% of CTs are stillborn and an additional one-third die within 24 hours of birth. We report an undiagnosed case of ischiopagus-tetrapus CTs delivered vaginally, with difficulty needing bilateral episiotomy. The bodies of two fetuses were fused laterally from mid-abdomen to pelvis along with single umbilical cord. There were two heads, four separate limbs, with fusion at pelvic region, and partially fused male external genitalia. The CTs were cyanosed and stillborn. Postnatal period was uneventful.

PDF Share
  1. Daskalakis G, Pilalis A, Tourikis I, Moulopoulos G, Karamoutzous I, Antsaklis A. First trimester diagnosis of dicephalous conjoined twins. Eur J Obstet Gynecol Reprod Biol 2004 Jan;112(1):110-113.
  2. Sangari SK, Khatri K, Pradhan S. Omphalopagus ischiopagus tetrapus conjoined twins—a case report. J Anat Soc India 2001;50(1):40-42.
  3. Zhang XS, Feng ZG, Xiong QX, Li MJ, Tang DX. Successful separation of ischiopagus tetrapus conjoined twins. World J Pediatr 2007 Aug;3(3):228-231.
  4. Quiroz VH, Sepulveda WH, Mercado M, Bermudez R, Fernandez R, Varela J. Prenatal ultrasonographic diagnosis of thoracopagus conjoined twins. J Perinat Med. 1989;17: 297-303.
  5. Barth RA, Filly RA, Goldberg JD, Moore P, Silverman NH. Conjoined twins: pre-natal diagnosis and assessment of associated malformations. Radiology. 1990;177:201-207.
  6. Castillo RA, Cuevas E, Arias D, Dominguez CA, Molina- Freaner F. The genetic structure of the gynodioecious Kallstroemia grandiflora (Zygophyllaceae): the role of male sterility and colonization history. Heredity. 2006;97:269-674.
  7. Spencer R. Anatomic description of conjoined twins: a plea for standardized terminology. J Pediatr Surg 1996 Jul;31(7): 941-944.
  8. O'Neill, JA Jr. Conjoined twins. In: O'Neill JA Jr, Rowe MI, Grosfeld JL, Fonkalsrud EW, Coran AG, editors. Pediatric surgery. 6th ed. Philadelphia (PA): Mosby;2006.p.2080.
  9. Turner RJ, Hankins GDV, Weinreb JC, et al. Magnetic resonance imaging and ultrasonography in the antenatal evaluation of conjoined twins. Am J Obstet Gynecol. 1986;155:645-649.
  10. Bart Y, Bartal MF, Sibai BM, Shina A, Mazaki-Tovi S, Eisen IS, Hendler I, Baum M, Schiff E. The Impact of Sperm and Egg Donation on the Risk of Pregnancy Complications. Am J Perinatol. 2018 Jul 21. doi: 10.1055/s-0038-1667029.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.