Thoraco-omphalopagus conjoined twins

Abstract

They were born at the Mario Catarino Rivas Hospital via cesarean section, with a monochorionic pregnancy, monoamniotic, alive, both male, single umbilical cord with 2 arteries, 1 vein. Total measurement: 3,040 grams, chest perimeter 41.5 cm, abdominal perimeter 43 cm, head perimeter 29 cm. Initial evaluation: single heart rate less than 60 beats per minute, shallow irregular breathing, flaccid muscle tone, absent, pale reflexes. They die from cardiorespiratory arrest at 18 minutes of life. Maternal History: 18-year-old primigravida, without pathological or gynecological-obstetric history, without prenatal control with ultrasound at 34.3 weeks of pregnancy reporting a heartbeat, fetal mirror image, weighing 2,919 grams.
Siamese twins: Development theories: Partial fission (During day 15-17 of gestation, monochorionic-monoamniotic twins present incomplete separation of the bilaminar embryonic disc) and secondary fusion (Independent embryos with subsequent union).1 Thoraco-omphalopagus: Siamese twins more common, frequency of 28%.2 They are characterized by a complex heart with symmetrical contribution between twins. In addition, they have a united liver, diaphragm and proximal intestines. Prognosis: They are rarely candidates for surgery for cardiac involvement.