Conjoined twins: an obstetrician's guide to prenatal care and delivery management

J Perinatol. 2021 Oct;41(10):2424-2431. doi: 10.1038/s41372-021-01107-5. Epub 2021 Jun 22.

Abstract

Objective: Obstetricians infrequently encounter conjoined twins. Much of the clinical care literature focuses on postnatal management from a neonatology and pediatric surgery perspective; guidance on obstetrical management is limited. We outline steps for prenatal evaluation, obstetrical care, and delivery planning.

Study design: Experiences with two cases of conjoined twins.

Results: We identified several points throughout the planning, delivery, and postnatal process that are important to highlight for optimizing clinical outcome, patient safety, and parental satisfaction.

Conclusion: After diagnosis, patients should be referred to a center experienced in the management of conjoined twins. Specialists in fields including maternal fetal medicine, pediatric surgery, neonatology, and radiology play a vital role in the management of these patients. Early referral allows for timely family counseling and decision-making. Prenatal evaluation beyond the first trimester should include a detailed ultrasound, fetal echocardiogram, and fetal MRI. 3D printed life-sized models can improve delivery planning and patient understanding.

MeSH terms

  • Child
  • Female
  • Humans
  • Pregnancy
  • Pregnancy Trimester, First
  • Prenatal Care
  • Twins, Conjoined* / surgery
  • Ultrasonography
  • Ultrasonography, Prenatal