Greco PS, Pitts D, Weadock WJ, Ladino-Torres M, Laventhal NT, Mychaliska G, Treadwell MC, and Carver A. Conjoined twins: an obstetrician's guide to prenatal care and delivery management. J Perinatol 2021.
Journal of perinatology : official journal of the California Perinatal Association
OBJECTIVE: Obstetricians infrequently encounter conjoined twins. Much of the clinical care literature focuses on postnatal management from a neonatology and pediatric surgery perspective; guidance on obstetrical management is limited. We outline steps for prenatal evaluation, obstetrical care, and delivery planning.
STUDY DESIGN: Experiences with two cases of conjoined twins.
RESULTS: We identified several points throughout the planning, delivery, and postnatal process that are important to highlight for optimizing clinical outcome, patient safety, and parental satisfaction.
CONCLUSION: After diagnosis, patients should be referred to a center experienced in the management of conjoined twins. Specialists in fields including maternal fetal medicine, pediatric surgery, neonatology, and radiology play a vital role in the management of these patients. Early referral allows for timely family counseling and decision-making. Prenatal evaluation beyond the first trimester should include a detailed ultrasound, fetal echocardiogram, and fetal MRI. 3D printed life-sized models can improve delivery planning and patient understanding.
ePub ahead of print