A very rare form of conjoined twinning: Diprosopus twins diagnosed in the first trimester of pregnancy by transvaginal ultrasonography

Abstract

Diprosopus twinning (two faces, one head, and one body) is extremely rare with a reported frequency of 1/180 000-1/15 000 000. We reported diprosopus twins diagnosed in the first trimester in a fetal demise case of a 21-year-old woman in her first pregnancy. Ultrasonography showed an in utero ex fetus with the bifid appearance of the cranium, two faces, two upper and two lower extremities and one body. The pregnancy was terminated using misoprostol. Macroscopic appearance confirmed the diagnosis with an additional finding of open spina bifida at the lumbosacral region. Therapeutic termination before 24 weeks of pregnancy can be offered following the early diagnosis of inseparable twins with severe conjoined anomalies. Diagnosis of conjoined twins in early gestation by ultrasonography with Doppler examination and magnetic resonance imaging (MRI) allows us to give adequate counselling to families to enable them to continue with or to terminate the pregnancy. © 2012 by Türkiye Klinikleri.