Conjoined Twins

January 11, 2023
Janelle Thomas MSN, RN
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Conjoined twins require the highest levels of personalized care and attention to ensure the healthiest and best possible outcomes. No two cases are ever alike, and the situation can change depending on where the two babies are joined, which organs they share, and any related complications that may have developed.

This guide provides an informative overview of how doctors diagnose conjoined twins, how this phenomenon develops, and the options for care and treatment.

What are conjoined twins?

Conjoined twins is the term for identical twins who develop some degree of physical connection in the womb, or do not fully separate. Identical twins usually develop from a single egg that splits into two separate embryos with complete organs. With conjoined twins, this separation does not fully occur, or may potentially be the result of two embryos fusing together in the womb.

Conjoined twins can develop in a wide range of different ways, and are generally categorized by where and how the two bodies are connected. Conjoined twins can be connected at the chest, abdomen, spine, pelvis, or head. The point of connection can have an effect on factors such as survivability and whether or not separation surgery is viable.

Why are they called Siamese twins?

Once more widely known as Siamese twins, conjoined twins has become the more commonly accepted term for this condition. The term Siamese twins originated from the case of Chang and Eng Bunker, two conjoined twins who were born in Siam, now Thailand, in the 19th century. In fact, cases of conjoined twins have been recorded in locations around the world since as early as 300 CE.

Statistics and Prevalence of Conjoined Twins

Births of conjoined twins are extremely rare. By some estimates, approximately one in every 49,000 births are conjoined twins, although it could be as low as one in 189,000. According to records, about half of all conjoined twins are stillbirths, and an additional third typically die within the first day, although survival rates have steadily improved.

About 70% of conjoined twins born alive are female. Additionally, 75% of all conjoined twins are joined somewhere around the chest and share some organs. There is a somewhat higher prevalence of conjoined twins in Africa and Southwest Asia, although the causes are not fully understood.

What causes conjoined twins?

Due to the rarity of the condition, the causes of conjoined twins are not fully understood. Currently, doctors and researchers are not able to identify genetic factors or environmental risk factors that could make conjoined twins more likely to occur.

Diagnosis of Conjoined Twins

Conjoined twins are usually diagnosed during pregnancy on a routine ultrasound. Doctors will continue to monitor the development of the fetus in the womb to assess the point of connection and overall development. Additional diagnosis and testing will usually occur after birth to assess which organs are being shared and the possibility of separation surgery.

Planning for Delivery

Pregnancies with conjoined twins have a high degree of complication, and will require delivery by cesarean section. Similar to identical twins, conjoined twin pregnancies also have a high likelihood of premature births. Since all cases of conjoined twins are different, once the twins have been diagnosed as conjoined, obstetricians and other specialists will work to create a personalized birth plan with the mother and family.

Management and Treatment for Conjoined Twins

Survival rates for conjoined twins continue to improve, particularly for twins who live past the first day after delivery. Treatment options will largely depend on body structure and shared organs. Conjoined twins will be carefully monitored and treated during the early weeks of life while development is assessed.

Separation Surgery for Conjoined Twins

In some cases, it is possible to surgically separate conjoined twins. This decision will usually depend on which organs and body structures, such as the spine, the twins share. For example, conjoined twins with a single heart will not be candidates for separation surgery.

Emergency surgery may be required to save one of the twins if the other dies or is threatening the survival or health of the other twin.

The decision to undergo separation surgery can also depend on the odds of survival and the extent of care that may be needed after surgery compared to twins who do not undergo a procedure. Separation surgery will typically be performed between six months to a year after birth, if it is deemed to be a safe viable option.

Caring for Conjoined Twins or Previously Conjoined Twins

Whether surgically separated or not, conjoined twins will have extensive care needs throughout life. Depending on circumstances, conjoined twins may require assistance with mobility, nutrition, dressing, and other daily needs. Additionally, conjoined twins can expect to require ongoing medical attention to assess complications and monitor for potential problems that may arise.

A large number of families with conjoined twins require or benefit from the assistance of home health professionals. Some cases require constant support from highly specialized services while other families may need more limited help. A qualified and experienced home health agency can work to design a care plan that fits any family’s needs.

Contact Care Options for Kids For Pediatric Home Health Care

It can be hard to balance your time between work, home, and caring for a child. That’s why our team of skilled professionals at Care Options for Kids is here to help.

Our home health care services offer support in the comfort of your home. We refer loving and competent nurses to provide customized care for families — from a few hours a day to around-the-clock supervision. Contact us directly to speak with a home health care professional or request a free in-home assessment. Together we can determine the best plan of action to keep your loved ones happy and healthy.

If you are considering pediatric home health care services, contact the caring staff at Care Options for Kids. Call today at (888) 592-5855.