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Federación Mexicana de Ginecología y Obstetricia, A.C.

2018, Number 12

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Ginecol Obstet Mex 2018; 86 (12)

Conjoined twins (siamese): description of anatomopathological findings

Gómez-Cadena JD, Sandoval-Martínez DK

Language: Spanish
References: 20
Page: 823-830
PDF size: 428.61 Kb.


ABSTRACT

Objective: Description of the anatomopathological and placental findings in a series of autopsies of 5 conjoined twins.
Materials and Methods: Series of cases of autopsies performed between 2013- 2018 of patients between 14-30 weeks of gestation, with diagnosis of conjoined twins.
Results: Five cases of conjoined twins, product of multiparous mothers, 3 of these presented intrauterine death and 2 deaths within a few minutes of life. Three cases corresponded to ventral junctions (2 thoracoomphalopagus and 1 cephalopagus) and two to lateral junctions of parapagus type. A single heart was observed in the thoracoomphalopagus twins and separated cardiac systems in the remaining three where there was distal aortic fusion. In 4 cases the liver was found fused with two independent bile ducts. The umbilical cords of the cases of ventral union presented 5 blood vessels; those with lateral junction presented a trivascular umbilical cord. The placentas showed varying degrees of preuterine hypoxic pattern and changes of Maternal Vascular malperfusion of the Placental Bed.
Conclusions: Ventral fusions have varying degrees of shared structures; the greater the fusion of the internal organs, the smaller the number of umbilical vessels will be. Of the proposed etiological theories, it is the so-called spherical theory, which best supports the variable degrees of fusion and how it can be saltatory on the vertical axis.


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