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Ginecología y obstetricia de México
Print version ISSN 0300-9041
Abstract
GOMEZ-CADENA, Juan David and SANDOVAL-MARTINEZ, Diana Katherine. Conjoined twins (siamese): description of anatomopathological findings. Ginecol. obstet. Méx. [online]. 2018, vol.86, n.12, pp.823-830. Epub Sep 30, 2020. ISSN 0300-9041. https://doi.org/10.24245/gom.v86i12.2449.
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.
Keywords : Conjoined twins; Fetuses; Placental findings; Multiparous mothers; Cephalopagus; Parapagus; Umbilical cord.