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Conjoined twins

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https://www.readbyqxmd.com/read/28231064/three-dimensional-ultrasound-for-prenatal-assessment-of-conjoined-twins-additional-advantages
#1
Tuangsit Wataganara, Pornpimol Ruangvutilert, Prasert Sunsaneevithayakul, Kusol Russameecharoen, Katika Nawapun, Nisarat Phithakwatchara
Conjoined twins are a rare, but serious, complication of monozygotic twins. Early prenatal diagnosis of conjoined twins is increasingly made with transvaginal ultrasound and color Doppler studies. Most prenatally diagnosed conjoined twins are terminated due to the high perinatal mortality, but advancement in pediatric surgery has allowed for successful postnatal separation in a small number of cases, and some parents may consider this option over termination of pregnancy. It is important to get a detailed prenatal ultrasound for the site and extent of fusion for an accurate categorization...
February 23, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28202184/high-prevalence-of-same-sex-twins-in-patients-with-cloacal-exstrophy-support-for-embryological-association-with-monozygotic-twinning
#2
Brenna S Fullerton, Eric A Sparks, Amber M Hall, Cristine S Velazco, Biren P Modi, Dennis P Lund, Tom Jaksic, W Hardy Hendren
PURPOSE: Previous studies have hypothesized that cloacal exstrophy may be caused by errors early in embryological development related to monozygotic twinning. This study reports the prevalence of twins in a large cohort of patients with cloacal exstrophy. METHODS: Patients with cloacal exstrophy treated 1974-2015 were reviewed for reports of multiple gestation or conjoined twinning. The genetic sex of the patient and their twin, and any mention of anomaly in the twin were recorded...
January 30, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28195364/conjoined-twins-from-conception-to-separation-a-review
#3
REVIEW
Asma Mian, Nader Ishak Gabra, Tanuj Sharma, Nitsa Topale, Jerzy Gielecki, R Shane Tubbs, Marios Loukas
Conjoined twins are suggested to result from aberrant embryogenesis. The two main theories proposed to explain the phenomena are fission and fusion. The incidence rate is 1 in 50,000 births; however, since about 60% of the cases are stillborn, the true incidence is approximated at 1 in 200,000. There is a higher predisposition towards female than male gender with a ratio of 3:1. Conjoined twins are classified based upon the site of attachment. The extent of organ sharing, especially the heart, determines the possibility and prognosis of a separation procedure...
February 13, 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/28190730/leftward-flow-determines-laterality-in-conjoined-twins
#4
Matthias Tisler, Thomas Thumberger, Isabelle Schneider, Axel Schweickert, Martin Blum
Conjoined twins fused at the thorax display an enigmatic left-right defect: although left twins are normal, laterality is disturbed in one-half of right twins [1-3]. Molecularly, this randomization corresponds to a lack of asymmetric Nodal cascade induction in right twins [4]. We studied leftward flow [5, 6] at the left-right organizer (LRO) [7, 8] in thoracopagus twins in Xenopus, which displayed a duplicated, fused, and ciliated LRO. Cilia were motile and produced a leftward flow from the right LRO margin of the right to the left margin of the left twin...
February 20, 2017: Current Biology: CB
https://www.readbyqxmd.com/read/28186636/triplet-pregnancy-from-the-transfer-of-two-blastocysts-demonstrating-a-twin-reversed-arterial-perfusion-sequence-with-a-conjoined-twins-pump-fetus
#5
Hongxia Yuan, Qichang Zhou, Jing Li, Shi Zeng
The incidence of monochorionic gestation is increased eight-fold following assisted reproductive techniques [1]. Monochorionic triplet pregnancies are rare, occurring in 1 in 45 500 deliveries [2], and are associated with high mortality and morbidity. Both conjoined twins and the twin reversed arterial perfusion (TRAP) sequence are unique complications of monochorionic pregnancy. The present study describes transvaginal ultrasonography findings from a monochorionic diamniotic triplet pregnancy at 10 weeks of gestation following double embryo transfer; a TRAP sequence, with a pair of conjoined twins as a "pump" fetus was identified...
February 10, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28132423/xenopus-an-ideal-model-organism-to-study-laterality-in-conjoined-twins
#6
REVIEW
Matthias Tisler, Axel Schweickert, Martin Blum
Conjoined twins occur at low frequency in all vertebrates including humans. Many twins fused at the chest or abdomen display a very peculiar laterality defect: while the left twin is normal with respect to asymmetric organ morphogenesis and placement (situs solitus), the organ situs is randomized in right twins. Although this phenomenon has fascinated already some of the founders of experimental embryology in the 19th and early 20th century, such as Dareste, Fol, Warynsky and Spemann, its embryological basis has remained enigmatic...
January 2017: Genesis: the Journal of Genetics and Development
https://www.readbyqxmd.com/read/28051055/thoracic-heteropagus-conjoined-twins-associated-to-an-omphalocele-report-of-a-case-and-complete-review-of-the-literature
#7
Kotti Ahmed, Ben Dhaou Mahdi, Zitouni Hayet, Louati Hamdi, Jallouli Mohamed, Mhiri Riadh
Heteropagus twins are an extremely rare event with an incidence of 1-2 million live births that represents, sometimes, a real challenge for paediatric surgeons. The majority of cases have complete or partial duplication of the pelvis and/or lower extremities. Thoracic heteropagus conjoined twins is a rare condition in which a grossly defective foetus (the parasite) is attached to the thorax of the main foetus (the autosite). We describe a case of a parasitic heteropagus attached at the chest wall with a rare presentation of giant exomphalos on the autosite...
October 2016: African Journal of Paediatric Surgery: AJPS
https://www.readbyqxmd.com/read/28038484/-the-first-record-of-the-delivery-of-conjoined-twins-in-the-srem-county-in-the-19th-century
#8
Jovan Maksimović, Marko Maksimović
In this paper is presented the first original document of the delivery of conjoined twins on the territory of the present-day Vojvodina. The document number 1224 consists of two handwritten quires. On the first page of the first quire are a description and a drawing of the delivered twins. The delivery was described and drawn by Dr. Ernest Furjaković, a shire physician in Ruma and the secondary physicus of the Srem County, who attended and handled the delivery. The conjoined twins were delivered in the night between 2 and 3 April 1852 in Mali Radinci, a small village in the Srem County nearby Ruma, in the far south of the Habsburg Monarchy...
December 2016: Acta Medico-historica Adriatica: AMHA
https://www.readbyqxmd.com/read/27977489/conjoined-twin-separation-integration-of-three-dimensional-modeling-for-optimization-of-surgical-planning
#9
Benjamin C Wood, Sarah R Sher, Benjamin J Mitchell, Albert K Oh, Gary F Rogers, Michael J Boyajian
Conjoined twinning is a rare anomaly, with an incidence of approximately 1 in 100,000 live births. There is a high perinatal mortality rate, but twins who survive pose reconstructive challenges that require meticulous preoperative planning. The authors describe the senior surgeon's career experience with conjoined twin separation, and the evolution of medical modeling and 3-dimensional imaging as a critical component in presurgical planning.The authors performed a retrospective review of all consecutive patients of conjoined twin separation at a single institution from January 2004 to December 2013...
January 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27942061/anaesthetic-challenges-in-conjoined-twins-separation-surgery
#10
Suvarna Kaniyil, Priyanka Pavithran, K K Mubarak, Taznim Mohamed
Conjoined twins are a rare congenital anomaly of unknown aetiology. We report the successful anaesthetic management of separation of ischiopagus tetrapus conjoined twins. The importance of a multidisciplinary approach, thorough pre-operative evaluation and planning, vigilant monitoring and anticipation of complications such as massive blood and fluid loss, haemodynamic instability, hypothermia and intensive, post-operative care are emphasised.
November 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27895537/tissue-expansion-in-children
#11
REVIEW
Tara L Braun, Kristy L Hamilton, Laura A Monson, Edward P Buchanan, Larry H Hollier
Tissue expansion is a well-established surgical method that has been creatively applied to the management of many congenital and acquired pediatric conditions, including the removal of giant congenital melanocytic nevi and the separation of conjoined twins. Careful preoperative planning and patient follow-up are required to achieve the proper results and minimize complications. Special considerations for pediatric patients are present during each step of the process, from patient selection to postoperative care...
November 2016: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/27872725/a-case-of-monocephalusrachipagus-tribrachius-tetrapus-in-a-puppy
#12
Adonis Pino, Arlenis Pérez, Aine Seavers, Guillermo Hermo
Caudal duplication (dipygus) is an uncommon pathologic of conjoined twinning. The conjoined malformation is classified according to the nature and site of the union. We report the presence of this malformation in a female crossbreed puppy. The puppy was delivered by caesarean section following a prolonged period of dystocia. External findings showed a single head (monocephalus) and a normal cranium with no fissure in the medial line detected. The thorax displayed a caudal duplication arising from the lumbosacral region (rachipagus)...
2016: Veterinary Research Forum
https://www.readbyqxmd.com/read/27832667/simulation-based-patient-specific-multidisciplinary-team-training-in-preparation-for-the-resuscitation-and-stabilization-of-conjoined-twins
#13
Nicole K Yamada, Janene H Fuerch, Louis P Halamek
The resuscitation of conjoined twins is a rare and complex clinical challenge. We detail how patient-specific, in situ simulation can be used to prepare a large, multidisciplinary team of health care professionals (HCPs) to deliver safe, efficient, and effective care to such patients. In this case, in situ simulation allowed an 18-person team to address the clinical and ergonomic challenges anticipated for this neonatal resuscitation. The HCPs trained together as an intact team in the actual delivery room environment to probe for human and system weaknesses prior to this unique delivery, and optimized communication, teamwork, and other behavioral skills as they prepared for the simultaneous resuscitation of two patients who were physically joined to one another...
November 10, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27783004/separation-of-thoraco-omphalo-ischiopagus-conjoined-twins-surgical-planning-management-and-outcomes
#14
Jeffrey G Trost, Lawrence O Lin, Sarah Jane Clark, David Y Khechoyan, Larry H Hollier, Edward P Buchanan
BACKGROUND: Conjoined twins are a rare medical phenomenon that offers a unique challenge for medical professionals. The complex anatomy of conjoined twins dictates their survival and amenability to separation, making each case different in terms of medical management, surgical planning, and patient outcomes. Thoraco-omphalo-ischiopagus twins, joined from the thorax to the pelvis, are one of the rarest orientations recorded in the medical literature, and successful separation of this subset of conjoined twins has not been documented...
November 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27781331/anesthetic-management-of-premature-conjoined-twins-posted-for-nonseparation-emergency-surgery
#15
Sunita Kulhari, Amit Rastogi, Ashish Kanaujia, Poulomi Biswas, Prabhat Kumar Singh
Craniopagus conjoined twins are rare, and the chance that an anesthesiologist might face the challenge of providing anesthesia for this condition is very rare. The incidence of conjoined twins ranges from 1 : 50 000 to 1 : 200 000 births. We describe the anesthetic management of a pair of premature craniopagus conjoined twins posted for emergency surgery prior to their separation.
December 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27749617/pygopagus-conjoined-twins-a-neurophysiologic-intraoperative-monitoring-schema
#16
Barrett Cromeens, Jennifer L McKinney, Jeffrey Leonard, Lance Governale, Judy Brown, Christina Henry, Marc Levitt, Richard Wood, Gail Besner, Monica P Islam
Conjoined twins occur in up to 1 in 50,000 live births with approximately 18% joined in a pygopagus configuration at the buttocks. Twins with this configuration display symptoms and carry surgical risks during separation related to the extent of their connection which can include anorectal, genitourinary, vertebral, and neural structures. Neurophysiologic intraoperative monitoring (NIOM) for these cases has been discussed in the literature with variable utility. We present a case of pygopagus twins with fused spinal cords and imperforate anus where the use of NIOM significantly impacted surgical decision making in division of these critical structures...
October 1, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/27723102/dicephalous-v-diprosopus-sharks-record-of-a-two-headed-embryo-of-galeus-atlanticus-and-review-of-the-literature
#17
V Sans-Coma, C Rodríguez, M A López-Unzu, M Lorenzale, B Fernández, L Vida, A C Durán
As far as is known, this paper gives the first description of a two-headed shark embryo belonging to an oviparous species, Galeus atlanticus (Carcharhiniformes: Scyliorhinidae). The specimen was detected among 797 embryos intended for cardiovascular studies, which represents a defect incidence of 0·13%. Each head had a mouth, two eyes, a brain, a notochord and five gill openings on each side. The two heads fused behind the gills. On the single body, there were four anticipated dorsal fins, two anterior, right and left and two posterior, right and left...
January 2017: Journal of Fish Biology
https://www.readbyqxmd.com/read/27704687/diprosopus-systematic-review-and-report-of-two-cases
#18
María Paz Bidondo, Boris Groisman, Agostina Tardivo, Fabián Tomasoni, Verónica Tejeiro, Inés Camacho, Mariana Vilas, Rosa Liascovich, Pablo Barbero
BACKGROUND: Diprosopus is a subtype of symmetric conjoined twins with one head, facial duplication and a single trunk. Diprosopus is a very rare congenital anomaly. METHODS: This is a systematic review of published cases and the presentation of two new cases born in Argentina. We estimated the prevalence of conjoined twins and diprosopus using data from the National Network of Congenital Anomalies of Argentina (RENAC). RESULTS: The prevalence of conjoined twins in RENAC was 19 per 1,000,000 births (95% confidence interval, 12-29)...
December 2016: Birth Defects Research. Part A, Clinical and Molecular Teratology
https://www.readbyqxmd.com/read/27647471/ep20-07-conjoined-twins-detected-during-routine-ultrasonography-scan-at-20-weeks-gestational-age
#19
O S Hassan
No abstract text is available yet for this article.
September 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27524469/the-2016-satellite-meeting-of-the-international-society-of-twin-studies-an-overview-tribute-to-irving-i-gottesman-research-mz-twinning-after-single-embryo-transfer-twin-study-of-mononucleosis-cerebral-injury-after-twin-to-twin-transfusion-syndrome-surgery-human
#20
Nancy L Segal
The 2016 Satellite Meeting of the International Society of Twin Studies took place on June 20 in Brisbane, Australia. The host institution was the QIMR Berghofer Medical Research Institute. An overview of selected presentations and activities is provided. This synopsis is followed by a brief tribute to the recent passing of our esteemed colleague, Dr Irving I. Gottesman. Next, there are summaries of research on monozygotic twinning after single embryo transfer, a twin study of mononucleosis susceptibility, cerebral injury following twin-to-twin transfusion syndrome surgery, and a correction and clarification regarding an article by Segal (2016) on the Brazilian Twin Registry...
October 2016: Twin Research and Human Genetics: the Official Journal of the International Society for Twin Studies
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