2009 Volume 61 Issue 1 Pages 1-6
The frequency of conjoined twins has been estimated to be 1 in 50,000 gestations, but as more than 60% of the conjoined twin cases succumb in utero or are stillborn, the true incidence is around 1 in 200,000 live births. Female conjoined twins predominate over male conjoined twins with a ratio of 3:1. We present a case of “Cephalopagus”, which was diagnosed by realtime 3-dimensional ultrasound imaging at 14 weeks of gestation. The patient was a 28-year-old primiparous G0P0 woman with no history of excessive alcohol consumption, viral infection, drug ingestion, or exposure to radiation during pregnancy. Realtime 3-dimensional and color doppler ultrasound revealed fused heads, faces and chests and two separate lower bodies. The fetuses were of approximately equal size, and their combined weight was 60 g and their heights were both 11.5 cm. They were conjoined along the midline of upper bodies to the umbilicus, which was single. All upper and lower limbs were normally developed. We diagnosed the conjoined twins as “Cephalopagus” at 14 weeks of gestation. With the clear realtime 3-dimensional presentation of the anomaly, the family decided to have the pregnancy terminated. Early prenatal diagnosis of conjoined twins allows better counseling of the parents regarding the management options, including continuation of pregnancy with post-natal surgery and termination of pregnancy. [Adv Obstet Gynecol, 61 (1) : 1-6, 2009 (H21.2)]
