You've probably seen it in movies, about twins who are born joined together. This can happen, but it's a very rare medical condition. Simply put, conjoined twins are twins who are born physically joined to each other. This condition can cause complications during pregnancy, during childbirth, and after birth. Although it can be a sensitive topic to talk about, it's important to be aware of it.
Sometimes these babies can be successfully separated through surgery. But not all of them can be separated. This is because of the way the babies are connected and the internal organs they share. Before deciding whether or not they can be safely separated, specialists do a lot of tests. Tests like ultrasound scans, MRI scans, and fetal echocardiography, which take a map of the babies' hearts, can help us better understand what organs they share.
Why is this happening? What is the reason?
Scientists still haven't found a single, definitive reason for this, but there are two main theories that explain it.
1. Fission Theory: According to this theory, the embryo in the early stages begins to divide into two. Normal twins ( Identical Twins ) are formed when this embryo completely divides into two. But what happens here is that the embryo does not completely divide into two and separate, but continues to grow after being joined together at some point.
2. Fusion Theory: According to this theory, a single fertilized egg first divides completely into two, forming two identical embryos. However, in the very early stages of embryonic development, these two embryos fuse together again.
This condition is very rare. It is usually reported to occur in about one in 50,000 or 60,000 births. It is also noteworthy that about 70% of these children are girls. Sadly, many children conceived in this way die in the womb or shortly after birth.
The important thing is that this condition is not affected by the mother's age, race, or anything else. Also, after such a pregnancy, there is no obstacle for you to conceive another child normally.
How does this condition affect pregnancy?
Pregnancy with conjoined twins is considered high-risk and requires close monitoring by specialist doctors throughout this period.
How do you recognize this?
Doctors can usually detect this condition during an ultrasound scan during pregnancy, usually in the first or second trimester. Sometimes it can be detected as early as 7-12 weeks.
If the scan confirms this, your doctor will suggest several more tests:
- MRI (Magnetic Resonance Imaging): This allows us to see very clearly where the two children are connected and what organs they share.
- Echocardiogram: This checks the function of the child's two hearts and whether they are connected together.
What are the symptoms?
A pregnant mother cannot tell if she is having conjoined twins by symptoms alone. The symptoms are the same as those that usually occur during a twin pregnancy, but they are slightly more severe.
- Extreme fatigue, nausea, and vomiting early in pregnancy.
- The uterus grows faster than if there was only one baby.
Childbirth is usually performed by C-section , for the safety of both mother and child. During the delivery , separate medical teams are prepared for each child.
What are the different ways these children are connected?
Conjoined twins are not all connected in the same way. They are classified according to the location of their connection. See the table below to understand this information clearly.
| Type | Location and description of the connection |
|---|---|
| From the chest (Thoracopagus) | The most common type. They are connected face to face at the chest. They often share a single heart and liver. |
| From the abdomen (Omphalopagus) | It is attached below the breastbone, near the sternum. It may share the liver, gallbladder, and upper parts of the digestive system. |
| From the lower back (Pyopagus) | It extends from the back and is connected to the lower back. It can share the genitals, urinary system, and lower parts of the digestive system. |
| From the pelvis (Parapagus) | The pelvis is connected to the sides through the pelvis. |
| From the head (Craniopagus) | The skull is connected at the top. The brain is often connected, but not always. |
| Along the spine (Rachipagus) | Very rare. Along the back, the entire spine remains connected. |
Can these children be separated surgically?
This is the biggest problem for everyone. Not all conjoined twins can be separated. Especially if they both share a single vital organ, such as the same heart, surgery may not be possible.
Doctors usually wait between 3 months and a year after a child is born before deciding on surgery. This is to give the child time to become strong enough to withstand surgery. It also gives doctors the opportunity to better study their body structure and organ distribution.
However, in some emergencies , emergency surgery may be necessary. For example, if one child dies or develops a life-threatening condition, surgery may need to be performed quickly to save the life of the other child.
These surgeries are very complex. They require a hospital with specialized knowledge and facilities. Even after the surgery, children need various treatments, such as physical therapy, for a long time.
What are the chances of survival?
Sadly, the survival rate of these children is not very high.
- More than 50% of conjoined twin pregnancies end in miscarriage or stillbirth.
- About 35% of babies born die within 24 hours because their organs cannot support two bodies.
- Only a small number, about 25%, of the surviving children qualify for surgery.
- About 60% of children who are surgically separated survive.
But there is good news. Thanks to improved scanning technology and surgical techniques, more conjoined twins are surviving and being successfully separated today than ever before.
Take-Home Message
- Conjoined twins are a very rare type of twins who are born joined together at birth.
- The cause of this condition has not yet been definitively determined, and it is not the mother's fault.
- This type of pregnancy is very risky and is diagnosed through scans such as ultrasound and MRI.
- Whether or not the twins can be separated depends on how they are connected and what organs they share. It is a very complex process.
- If you have any doubts about such a situation, it is very important to talk openly with your doctor about it and get the right advice and guidance.
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