Conjoined twins with a single heart with complex disease

Resumo

Conjoined twins are a rare presentation with an estimated incidence of 1: 50000 pregnancies. They occur due to a random event, not related to heredity, maternal age or delivery conditions. This article is a case-report of a pair of female thoraco-omphalopagus conjoined twins, who were diagnosed during prenatal period through a morphological ultrasound. After a 24-week gestation period, the female newborns had a total weight of 1100g, and were born of a cesarean section. Both fetuses scored 3 in the Apgar scale in the first minute, getting down to a score of 1 in the fifth minute. Soon after birth, the newborns were referred to the Intensive Care Unit, where supportive measures were taken and transthoracic Doppler echocardiography was performed for diagnostic confirmation. The echocardiogram showed that there was only one heart for both newborns with a complex heart disease. In 75% of the cases of thoraco-omphalopagus conjoined twins, structural heart disfigurements are found in at least one of the fetuses. Besides, in approximately 80-90% of the cases, the cardiac abnormalities in the heart junction are far too complex, making it impossible to surgically separate the fetuses. This way, a structural and functional analysis of the heart is considerably more efficient post-birth, and it’s shown to be more accurately done through an echocardiography. This reveals that cardiac changes are a crucial factor in the fetal and postnatal evaluations of conjoined twins. Such procedures are a way of providing adequate medical recommendations, which may always be honest and based on scientific evidence.

Descriptors: Diseases in Twins; Twins, Conjoined; Heart Diseases.

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