Conjoined twins – morphoclinical aspects

Abstract

Introduction. One of the most interesting and hard to manage congenital malformations refers to legendary conjoined twins. This abnormality has a rare occurrence in medical practice. Frequently, the twins are born dead, but there are few cases when they survive. Current technology is lending a helping hand in the early diagnosis of these conditions. More commonly known as „Siamese twins”, this phenomenon is shrouded in mystery and considered a curiosity by general public. The cause of conjoined twins is unknown. Two theories have been postulated to explain the origin of this phenomenon: the fission and the fusion theories. Until now, more than 250 separation surgeries have taken place around the world and with very rare incidence of successful separation surgery as per the current literature available. Aim of the study. To analyze the history, epidemiology, etiology, diagnosis, management and other morphoclinical aspects of conjoined twins. Materials and methods. Scientific articles were selected from PubMed, Hinari and Cambridge University press databases. The research was not delimited to a specific period of time and was supplemented with bibliographic data from statistic sites, of the Ministry of Health, Labour and Social Protection of the Republic of Moldova, and the exhibits of the Anatomic Museum of Nicolae Testemițanu State University of Medicine and Pharmacy were analyzed. Results. The statistical analysis of the incidence and mortality for congenital malformations, chromosomal deformities and abnormalities of children under 18 in the Republic of Moldova for the years 2008-2018 has shown a peak in 2011-2012 years. Unfortunately, the rarity of the disease impede continuous improvements in diagnostic, management and separation techniques, so each case is an opportunity to introduce new techniques and methods to help in achieving the best possible results. Conclusions. Further work in epidemiology and molecular research is necessary to realize the etiology and pathogenesis involved in the development of this strange phenomenon of nature. Quick interventions geared toward rapid diagnosis and management should be implemented to help decrease maternal and neonatal morbidity and mortality. The evaluation of these children should be multidisciplinary, involving mainly obstetricians, pediatric anesthesiologists and pediatric surgeons.