Providers, read how to refer patients. What are conjoined twins? Usually, the connection is more complex. In some cases, children may share: Vital organs, like 1 heart Many structures, like several parts of the digestive , genital and urinary systems A large portion of the body, like all of the lower body Part of the brain and skull What causes conjoined twins? There are 2 ideas about what causes conjoined twinning: The egg divides late and does not divide all the way.
The egg divides but then joins back together. Compassionate care, starting with diagnosis Usually, parents find that their twins are conjoined when the mother has an ultrasound during pregnancy. Our Prenatal Diagnosis and Treatment team will do a detailed evaluation. We provide information and compassionate support to guide you in finding the care that is right for your family.
Our transport team of physicians, nurses and respiratory therapists are national leaders in safely moving fragile newborns. We are skilled and equipped to care for the sickest newborns. Each set of conjoined twins is unique.
Other specialists as needed will care for your child. These may include cardiologists, lung specialists, anesthesiologists, urologists, orthopedic surgeons, plastic surgeons, neurosurgeons, cardiac surgeons, physical therapists, occupational therapists and nutritionists. Even so, surgery is not always the best choice. We work with you to decide on the best treatment for your babies. Whether your twins are separated or remain joined, we provide complete care through childhood and into the early adult years.
We have all the experts your family needs. We know how challenging and scary it can be to find a medical problem during pregnancy.
Your family has a full team behind you, including doctors, nurses, lactation specialists and social workers. We help you fully understand your treatment options and make the choices that are right for your family. We connect you to community resources and support groups. We can help with financial counseling, schooling for other children in the family, housing, transportation, interpreter services and spiritual care.
Learn about our services for patients and families. Conjoined Twins Symptoms Conjoined twins may be connected to each other in many different ways. Their health and any symptoms depend on: How each baby developed. Which structures they share. How well their organs work. Their lung development. Conjoined twins are usually born early and may have breathing problems. Doctors group conjoined twins into the following categories based on where they are joined.
Diagnosing Conjoined Twins During pregnancy In most cases, doctors see that twins are conjoined during a routine ultrasound late in the first trimester of pregnancy or in the second trimester.
Creating a treatment plan Treatment for each set of twins is unique. Both children may have all the organs and other structures they need. They may share some structures or vital organs, like a heart. It may not be possible to separate the twins in all cases.
Their bodies may be able to support both their lives, or it may be hard for 1 or both to survive because of health problems. Surgery may be the best option: For the physical health of both children, while also giving them the chance to have independent bodies and lives Because 1 twin cannot survive because of a severe birth defect and separation is the only way to give the other twin a chance to live Usually, twins have separation surgery in the first 3 months to 12 months of life.
Any procedures your babies may need to prepare them for separation. This makes it easier for doctors to do the surgery and easier for the twins to withstand the surgery. Related Programs. Specialists involved in your care will likely include neonatologists, cardiologists, advanced practice nurses and maternal-fetal medicine specialists, among others. One of the many procedures required to prepare twins for separation is the insertion of tissue expanders to increase the skin surface available to cover exposed tissue after surgery.
As separated twins recover after surgery, they are closely followed by nutritionists, developmental pediatricians and other specialists to ensure their ability to thrive and grow. Since , pairs of conjoined twins have been referred to the Center for Fetal Diagnosis and Treatment, and 40 pairs have undergone prenatal evaluation.
Not all conjoined twins are candidates for separation, and the success rates for separating conjoined twins vary depending on the connection. Watch this video tour to learn what to expect at your first visit to the Wood Center for Fetal Diagnosis and Treatment. From the moment of referral through delivery and postnatal care, your family can expect a supportive experience when you come to us with a diagnosis of a birth defect.
Conjoined Twins. Contact Us Online. What are conjoined twins? The following imaging tests are used to diagnose and evaluate conjoined twins: Fetal ultrasound : a safe, noninvasive procedure that uses high frequency sound waves to provide detailed high-resolution images, including 3-D and 4-D views.
Our team of board-certified radiologists uses highly specialized equipment to ensure the best images possible are obtained. Fetal echocardiogram : a noninvasive ultrasound procedure that assesses the structure and function of the fetal heart.
Fetal echocardiogram is the most important test for the evaluation of conjoined twins, as it determines if the twins share a heart and if so, where that connection occurs. It requires no sedation of mother or muscle relaxants for the fetus to obtain images.
Used with the ultrasound images, the fetal MRI adds another level of detail. The prognosis for conjoined twins depends on where the twins are connected. Conjoined twins are generally classified three ways: 75 percent are joined at the chest wall or upper abdomen thoracopagus and omphalopagus 23 percent are joined at the hips, legs or genitalia pygopagus and ischiopagus 2 percent are joined at the head craniopagus The common twin types include: Thoracopagus: the most common type of conjoined twin, which along with omphalopagus, represents about 75 percent of cases.
One Becomes Two. When the conjoined twins share a heart, successful surgical division is usually not possible. Separation success rates Since , pairs of conjoined twins have been referred to the Center for Fetal Diagnosis and Treatment, and 40 pairs have undergone prenatal evaluation. The natural history of prenatally diagnosed conjoined twins.
Journal of Pediatric Surgery , Providers Who Treat Conjoined Twins. Next Steps Contact Us. They are joined at the chest and abdomen. They are attached at the chest but share no major organs. Both survive. They are joined at the lower chest and abdomen and share a liver, pancreatic glands, and part of their small intestine.
November 8, - Are successfully separated following a hour procedure. They are joined back to back at the pelvis and lower spine, each with separate hearts, heads and limbs. August 29, - Are successfully separated after a hour surgery. October - Jacob Spates passes away. The cause of his death is not released. August 15, - Are successfully separated after a four-stage operation. Two operations took place in May, one in July and the final operation in August. They are attached at the lower chest and abdomen and share their chest wall, diaphragm, pericardium and liver.
November 7, - Are successfully separated after a seven-hour surgery at Children's Hospital Philadelphia. They are joined from the chest to the abdomen and have a conjoined liver. October 25, - An emergency surgery is performed to separate their liver. April 22, - Are successfully separated following 14 hours of surgery.
October 14, - A'zhari passes away. They are joined at the liver and the intestine. August 24, - Are successfully separated. They are joined at the chest, sharing a liver, heart lining, diaphragm, intestines and colon. February 17, - A team of 12 surgeons separate the sisters during a hour procedure.
They are joined at the lower chest and upper abdomen and share a liver, bladder, two kidneys and three legs. December , - Are successfully separated after 17 hours of surgery at Lucile Packard Children's Hospital Stanford in California.
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