You may have heard about conjoined twins in the newspapers and on TV. It's a very surprising and a bit sensitive topic, isn't it? When we hear something like this, a lot of questions come to our minds. So today, let's talk about these `(Conjoined Twins)` or conjoined twins in simple Sinhala that you can understand.
What are conjoined twins called?
Simply put, conjoined twins are two babies who are physically joined together, that is, by body parts. Doctors are still not sure exactly how this happens. But they think that when a baby starts to develop, that is, in the early embryonic stage when the mother's egg and the father's sperm combine, the embryo may split in two and stick together without completely separating, or two embryos that were originally separate may later fuse together (fusion). All twins born this way are identical . Also, more often than not, girls are born this way.
How common is this condition?
This is actually a very rare condition . Statistically, it occurs in about one in 50,000 pregnancies. Sometimes, when two babies are joined together in this way, the body parts that are joined do not develop sufficiently to survive. Therefore, most of the time (about 60%) such twins are stillborn or die shortly after birth . This is sad to hear, but it is true.
Are all conjoined twins born the same?
Yes, as mentioned before, twins born this way are always identical . That means they have the same genetic characteristics. Also, they are said to be more likely to be girls.
Why is this happening? What is the reason?
There are two main opinions on this.
1. Fission theory: This is the theory that when a baby first starts to develop, the embryo, which is a small ball of cells that are similar to each other, starts to divide in two. However, it does not completely separate, but sticks together at some point. Then the two stuck parts develop into two separate babies.
2. Fusion theory: In this, there are two separate embryos (balls of cells) that initially develop into twins. However, as these two embryos develop, they accidentally come together and connect at some point.
Both of these theories explain how conjoined twins can occur within the first 12-14 days after fertilization. However, scientists are still unable to pinpoint the exact cause of this phenomenon. This means that it is not due to anyone's fault.
Are there types based on how they are connected?
Yes, these are classified according to the location of the body where the two children are joined together. Special medical names are used to describe these types.
- If it involves the abdomen (belly): `(Omphalopagus)`
- If connected to the chest area: `(Thoracopagus)` - This is the most common type.
- From the top of the head to the nose, the face is connected to the face: `(Cephalopagus)`
- If only the head is involved: `(Craniopagus)`
- If the pelvis is connected to the face, it is called: `(Ischiopagus)`
- If the pelvis is joined side by side: `(Parapagus)`
- Rump-to-rump related names: `(Pygopagus)`
- Names related to the vertebral column: `(Rachipagus)`
Each of these types determines how the children's internal organs are shared, whether they can be separated, and the risk to their lives.
How do you recognize this during pregnancy?
This condition is usually diagnosed during pregnancy with an ultrasound scan . Sometimes it can be detected as early as 12 weeks of pregnancy . Then, an MRI scan can be done to confirm further and to see exactly how the babies are attached and how the internal organs are distributed.
With this early detection, doctors can anticipate potential complications and plan for what to do when the baby is born.
Can complications arise in a pregnancy like this?
Yes, when there are twins like this, the mother is more likely to have premature labor. However, if this condition is detected early, doctors can try to control it and give the babies the time they need to develop properly.
In most cases, babies are delivered by cesarean section (C-section) . This is the safest method for both mother and baby.
Can these twins be separated?
This is the biggest question for many people. Sometimes it's possible, sometimes it's not. It depends on many factors, such as how the children are connected, what organs they share, etc.
To do this successfully, specialists from various fields, including doctors and surgeons, need to work together as a team. Advanced `imaging` technologies (such as scans) and other tests help to understand the anatomy and physiology of both children.
The decision to separate children is sometimes very complex, and can even raise ethical questions. In such cases, the decision is made after extensive discussion between the parents, the medical team, and perhaps religious leaders and medical ethics experts.
After babies are born, they are divided into three main categories for separation:
1. No separation: Sometimes, separating children can be life-threatening or cause severe disabilities. In such cases, separation surgery is considered only after carefully considering the children's future quality of life.
2. Immediate separation: In some emergencies, immediate surgical separation is necessary to save the lives of either one or both babies.
3. Delayed separation: If the children's health is stable, the medical team may postpone the separation surgery for a while. This will give the children time to grow and develop. This will also increase their chances of survival after the surgery. Many doctors believe that it is better to perform this surgery when the children are about 9-12 months old . Then, this condition can be separated before it affects their mentality. Children who are separated later have a higher survival rate (about 80%) than those who are separated immediately.
Is there a way to prevent this situation?
This is a very sad fact. Because we do not know the exact cause of conjoined twins, there is no way to prevent them during pregnancy. It is important to understand that this is not the fault of either the mother or the father.
What can be said about the future of these children? (Prognosis)
The survival rates and quality of life of the children depend entirely on how the two children are connected. Here are the survival rates that are typically seen for each type:
- Omphalopagus: About 82% of the abdomen .
- Buttocks (Pygopagus): About 68%.
- Ischiopagus: About 63%.
- Thoracopagus: This has a low chance of survival.
- Parapagus: This also has a low chance of survival.
- Cephalopagus: From the top of the head to the bottom: The chances of survival are very low.
- Head only `(Craniopagus)`: Less chance of survival.
- Spinal cord (Rachipagus): This type of child cannot be separated.
Only about 60% of children who undergo separation surgery survive. However, doctors can help manage complications and improve the outlook for children.
Is it possible to live a healthy life even if you were born conjoined?
This also depends on how the babies are connected. With advances in medical science and surgical technology, some babies born conjoined can live completely normal, healthy lives after separation. Sometimes, even if separation is not possible, they can maintain a good quality of life under good medical supervision.
When can this be detected during pregnancy?
Usually, conjoined twins can be detected as early as 12 weeks into pregnancy . Your doctor can confirm this with an anomaly scan around 20 weeks.
What are the important questions to ask your doctor?
It's normal to have a lot of questions when you learn something like this. Don't worry. You can ask your doctor about these things and find out for sure:
- How are my two children connected? What organs do they use together?
- Will it be possible to separate my children?
- Need an immediate reservation?
- What can be done to prevent premature birth?
- Is there a team of specialized doctors to care for and treat my children before and after they are born?
As parents, the last thing you want to hear is that something unexpected has happened to your unborn baby. Since we don't know why conjoined twins happen, there's no way to prevent them. After a diagnosis like this, you'll need to work with a team of highly qualified medical professionals. They can monitor your baby's development, plan the delivery, and discuss surgical interventions. The way your baby is treated will depend on where they are joined and how much they share organs. However, many conjoined twins have surgical and medical options. It's normal to feel a range of emotions at this time, including fear, anger, guilt, and sadness. Remember, your medical team is there to support you every step of the way.
Finally, remember this (Take-Home Message)
Conjoined twins are a rare condition. The exact cause is unknown, so they cannot be prevented. However, early detection and proper medical management are very important. With the advancement of medical science, some children are successfully separated and have the opportunity to live a good life. It is difficult for parents to remain mentally strong in such a situation, but it is very important to know the right information, talk openly with doctors, and get the necessary support. Ask your doctor all your questions and do not be afraid.
` conjoined twins, siamese twins, twins, conjoined children, pregnancy, surgery, medicine
💬 අදහස් (0)
තවමත් කිසිදු අදහසක් පළ කර නොමැත. ඔබේ අදහස පළමු වරට මෙහි එක් කරන්න.
ඔබේ අදහස එක් කරන්න