Early separation of parasitic conjoined twins at a tertiary care hospital: A case report

IF 0.2 Q4 PEDIATRICS
Ahmad Yani , Wulan Ayudyasari , Kshetra Rinaldhy , Muhamad Luthfi Prasetyo , Nafissa Amanda Safinati Yani
{"title":"Early separation of parasitic conjoined twins at a tertiary care hospital: A case report","authors":"Ahmad Yani ,&nbsp;Wulan Ayudyasari ,&nbsp;Kshetra Rinaldhy ,&nbsp;Muhamad Luthfi Prasetyo ,&nbsp;Nafissa Amanda Safinati Yani","doi":"10.1016/j.epsc.2024.102945","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Conjoined twins is defined as twins that are physically fused in utero and at birth. Parasitic conjoined twins is a particularly rare form of conjoined twins, occurring in fewer than 1 in 1 million live births. The management of parasitic conjoined twins remains a challenge, lacking a universal consensus regarding the optimal timing for separation surgery.</div></div><div><h3>Case presentation</h3><div>A 31-week pregnant woman presented with a fetal emergency. Ultrasound at 27 weeks revealed conjoined abdominopagus twins sharing a single liver. At 31 weeks, only one fetal heartbeat was detected, requiring an urgent cesarean section. Two asymmetric female twins were delivered: Neonate A, who survived with an APGAR score of 7/9, and Neonate B, a stillbirth. Neonate A had ventriculomegaly, while Neonate B exhibited multiple congenital anomalies, including bilateral cleft lip, hypodactyly, hydrocephalus, and hydrops fetalis. Neonate A was stabilized and underwent successful early separation surgery. Postoperatively, Neonate A received intensive care, including respiratory support, broad-spectrum antibiotics, and treatment for a patent ductus arteriosus. At one-month follow-up, Neonate A was stable and recovering well.</div></div><div><h3>Conclusion</h3><div>Early separation of parasitic conjoined twins is recommended in cases with one stillborn or deceased twin, as it improves survival chances for the autosite. Delayed separation is advised for cases with two viable twins, allowing for organ maturation and reducing intraoperative complications.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"114 ","pages":"Article 102945"},"PeriodicalIF":0.2000,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pediatric Surgery Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2213576624001738","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction

Conjoined twins is defined as twins that are physically fused in utero and at birth. Parasitic conjoined twins is a particularly rare form of conjoined twins, occurring in fewer than 1 in 1 million live births. The management of parasitic conjoined twins remains a challenge, lacking a universal consensus regarding the optimal timing for separation surgery.

Case presentation

A 31-week pregnant woman presented with a fetal emergency. Ultrasound at 27 weeks revealed conjoined abdominopagus twins sharing a single liver. At 31 weeks, only one fetal heartbeat was detected, requiring an urgent cesarean section. Two asymmetric female twins were delivered: Neonate A, who survived with an APGAR score of 7/9, and Neonate B, a stillbirth. Neonate A had ventriculomegaly, while Neonate B exhibited multiple congenital anomalies, including bilateral cleft lip, hypodactyly, hydrocephalus, and hydrops fetalis. Neonate A was stabilized and underwent successful early separation surgery. Postoperatively, Neonate A received intensive care, including respiratory support, broad-spectrum antibiotics, and treatment for a patent ductus arteriosus. At one-month follow-up, Neonate A was stable and recovering well.

Conclusion

Early separation of parasitic conjoined twins is recommended in cases with one stillborn or deceased twin, as it improves survival chances for the autosite. Delayed separation is advised for cases with two viable twins, allowing for organ maturation and reducing intraoperative complications.
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
0.60
自引率
25.00%
发文量
348
审稿时长
15 days
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信