An interesting case of undiagnosed conjoined twins

Abstract

A 20 years old primigravida who presented to us at 36 weeks 3 days gestation with labor pains. She was perceiving fetal movements well, booked and immunized at a private hospital in Hosur. On examination, she was 7 cm dilated, well effaced, breech at 0 station. She was taken up for emergency lower segment cesarean section (LSCS) in view of primi with breech and mother not willing for vaginal delivery. An alive term 3.5 kg female paraphagus dicephalus twins was extracted. Extraction was difficult. Apgar was 3 at 1 minute and 5 at 5 minutes. The babies died after 45 minute. External examination showed that the twins were conjoined from the level of thorax downward. The twins had two heads, two upper limbs and a shared thorax, abdomen, pelvis and a single female external genitalia and single pair of lower limbs with CTEV (dicephalus, dibrachius, dispinous, thoraco-omphalopagus twins).