Treatment of conjoined twins depends on their unique circumstances — their health, where they're joined, and whether they share organs or other vital structures.
If you're carrying conjoined twins, you will be very closely monitored throughout your pregnancy. You will be best served by a team of doctors who work to learn as much as possible about your twins' anatomy, functional capabilities and prognosis after birth. Having this information can help your doctors form a treatment plan for your twins.
A surgical delivery (C-section) is planned ahead of time, often two to four weeks before the due date.
After your conjoined twins are born, you and your doctors must decide whether separation surgery should be attempted. An emergency separation may be needed if one of the twins dies, develops a life-threatening condition or threatens the survival of the other twin. More often, however, separation surgery is an elective procedure done two to four months after birth. Recent advances in prenatal imaging, critical care and anesthetic care have improved outcomes in separation surgery.
Many factors weigh heavily in the decision to pursue separation surgery, such as:
- Do the twins share vital organs?
- Are the twins healthy enough to withstand separation surgery?
- What are the odds of successful separation?
- What type of reconstructive surgery might be needed for each twin after successful separation?
- What issues would the twins face if left conjoined?
If the circumstances are grave and separation surgery isn't possible or you decide not to pursue the surgery, comfort care — such as nutrition, fluids, human touch and pain relief — is provided as needed.
April 10, 2013
- Gabbe SG, et al. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/das/book/body/208746819-4/0/1528/0.html. Accessed Feb. 10, 2013.
- Wen XR, et al. Thoraco-omphalopagus conjoined twins: Impact of ultrasound assessment on successful surgical separation. Clinical Imaging. 2013;37:138.
- Mandy GT. Neonatal outcome, complications, and management of multiple births. http://www.uptodate.com/home. Accessed Feb. 10, 2013.
- Jackson OA, et al. Conjoined twin separation: Lessons learned. Plastic and Reconstructive Surgery. 2012;129:956.
- Chen CP, et al. Conjoined twins detected in the first trimester: A review. Taiwanese Journal of Obstetrics & Gynecology. 2011;50:424.
- Rhodes JL, et al. Preoperative planning for the separation of omphalopagus conjoined twins The role of a multicomponent medical model. Journal of Craniofacial Surgery. 2013;24:175.
- Mutchinik OM, et al. Conjoined twins: A worldwide collaborative epidemiological study of the International Clearinghouse for Birth Defects Surveillance and Research. American Journal of Medical Genetics Part C: Seminars in Medical Genetics. 2011;157:274.
- Cunningham FG, et al. Williams Obstetrics. 23rd ed. New York, N.Y.: The McGraw-Hill Companies; 2010. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=46. Accessed Feb. 11, 2013.
- Chasen ST, et al. Twin pregnancy: Prenatal issues. http://www.uptodate.com/home. Accessed Feb. 10, 2013.
- Sharma D, et al. Cephalothoracopagus janiceps asymmetros twins: Antenatal sonographic diagnosis. Journal of Clinical Ultrasound. 2013;00:1.
- Rios LT, et al. Prenatal diagnosis and postnatal findings of cephalothoracopagus janiceps disymmetros: A case report. Case Reports in Medicine. 2012;00:1.
- Roque H, et al. Monoamniotic twin pregnancy. http://www.uptodate.com/home. Accessed Feb. 10, 2013.
- Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 15, 2013.