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Treatments and drugs
By Mayo Clinic staffTreatment of conjoined twins varies greatly depending on the circumstances.
Many parents make the difficult decision to end the pregnancy. Prognosis and quality-of-life issues weigh heavily in the decision, as well as the likelihood of successful separation. If the babies share a heart or brain, for example, separation surgery may not be possible.
If the parents choose to continue the pregnancy, mother and babies will be closely monitored throughout the pregnancy. A surgical (C-section) delivery is planned ahead of time, often two to four weeks before the due date.
After the conjoined twins are born, the parents and doctors must decide whether to attempt separation surgery. An emergency separation may be needed if one of the twins dies, develops a life-threatening condition or threatens the survival of the other twin. More often, however, separation surgery is an elective procedure done two to four months after birth.
Many factors weigh heavily in the decision to pursue separation surgery, such as:
- Do the twins share vital organs?
- Are the twins healthy enough to withstand separation surgery?
- What are the odds of successful separation?
- What type of reconstructive surgery might be needed for each twin after successful separation?
- What issues would the twins face if left conjoined?
If separation surgery isn't possible or the parents decide not to pursue the surgery, comfort care — such as nutrition, fluids, human touch and pain relief — is provided as needed.
- Cunningham FG, et al. Multifetal gestation. In: Cunningham FG, et al. Williams Obstetrics. 23rd ed. New York, N.Y.: McGraw Hill; 2010. http://www.accessmedicine.com/content.aspx?aID=6037146. Accessed Sept. 24, 2010.
- Winkler N, et al. The imaging spectrum of conjoined twins. Ultrasound Quarterly. 2008;24:249.
- Spitz L. First trimester diagnosis of conjoined twins. Prenatal Diagnosis. 2005;25:820.
- Amin S, et al. Live conjoined twins: A rare first trimester diagnosis during emergency department sonography. Emergency Medicine. 2010;39:e105.
- Roque H, et al. Monoamniotic twin pregnancy. http://www.uptodate.com/home/index.html. Accessed Sept. 24, 2010.
- Martinez-Frias ML, et al. Epidemiological and clinical analysis of a consecutive series of conjoined twins in Spain. Journal of Pediatric Surgery. 2009;44:811.
- Kokcu A, et al. Conjoined twins: Historical perspective and report of a case. Journal of Maternal Fetal Neonatal Medicine. 2007;20:349.
- Pajkrt E, et al. First-trimester diagnosis of conjoined twins. Prenatal Diagnosis. 2005;25:820.
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