Treatment of conjoined twins depends on their unique circumstances — their health, where they're joined, and whether they share organs or other vital structures.
Monitoring during pregnancy
If you're carrying conjoined twins, you should be closely monitored throughout your pregnancy. You'll likely be referred to a maternal and fetal medicine doctor who specializes in high-risk pregnancy. You may also be referred to other specialists such as pediatric surgeons, pediatric cardiologists and neonatologists.
Your doctors and others on your health care team learn as much as possible about your twins' anatomy, functional capabilities and prognosis to form a treatment plan for your twins.
A surgical delivery (C-section) is planned ahead of time, often two to four weeks before your due date.
After your conjoined twins are born, they're fully evaluated. With this information, you and your health care team members can make decisions regarding their care and whether separation surgery is appropriate.
Separation surgery is an elective procedure done two to four months after birth. Sometimes 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.
Many complex factors must be considered as part of the decision to pursue separation surgery. Each set of conjoined twins presents a unique set of considerations due to variations in anatomy. Questions may include:
- Do the twins share vital organs, such as the heart?
- 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 functional support will be needed after separation?
- What issues would the twins face if left conjoined?
Recent advances in prenatal imaging, critical care and anesthetic care have improved outcomes in separation surgery.
If surgery isn't an option
If separation surgery isn't possible or if you decide not to pursue the surgery, your team can help you meet the medical care needs of your twins.
If the circumstances are grave, medical comfort care — such as nutrition, fluids, human touch and pain relief — is provided.