Conjoined twin parapagus dicephalus

A multi-fetus pregnancy occurs when there are two or more embryos or fetuses present at once. The most obvious anatomical position of the fusion of the fetal components can be used to classify conjoined twins, a rare congenital abnormality with an incidence of 1.5 per 100,000 births. A 29-year-old multiparous pregnant woman came to Arifin Achmad hospital, Pekanbaru, Riau. The patient received a referral from an obstetrician because there was a foetal abnormality. The patient did not have any complaints when he came to the hospital. The results of the ultrasound examination showed that the intrauterine Gemelli foetus was alive and had conjoined twins (parapagus-dicephalus). There are 2 pairs of legs, 2 pairs of hands, 2 heads, and 2 hearts. The patient was then planned for abdominal termination of pregnancy. A caesarean operation was performed, and a baby boy was born with 2 heads, 4 arms, 2 hearts, and 2 legs. With the baby's birth weight of 4200 gm, birth length of 47 cm, and Apgar score of 7/8, anal atresia was also found in the fetus. Pregnancy with multiple fetuses carries a high risk of maternal and perinatal morbidity and mortality. The risk of complications for both the mother and the child must be reduced by the early diagnosis of multi-fetus pregnancies with conjoined twins.