04-28-2014, 11:06 AM
A Pennsylvania couple took their conjoined twins home from the hospital this weekend. The twins share a heart. So far, no set of conjoined twins who share a heart have been successfully separated without at least one of the twins dying.
Conjoined twins are rare -- one in 200,000 pregnancies result in the birth of conjoined twins and it's not always known that the babies are joined until very late in the pregnancy or after birth.
Conjoined twins happen when a woman produces a single egg that does not separate completely after it is fertilized. If it did divide completely, then the woman would give birth to identical twins. Fraternal twins are born from two separate fertilized eggs.
The overall survival rate of conjoined twins is from 5% to 25%, with about 75% of surgical separations resulting in at least one twin surviving. Approximately 200 pairs of conjoined twins are born alive each year, and about half die before their first birthday.
There have been several conjoined twins that were successfully separated surgically, but the chances of survival when they remain joined or when they are surgically separated depend in good part on the organs that the twins share.
Surgical separation is most risky when the twins share a heart or a head/brain tissue. However, it's not impossible for twins to survive such a separation. Australian doctors successfully separated these girls from Bangladesh back in 2009 -- they had been joined at the head.
![[Image: Trishna-and-Krishna-Bangladeshi-conjoined-twins.JPEG]](http://www.thaimedicalnews.com/wp-content/uploads/Trishna-and-Krishna-Bangladeshi-conjoined-twins.JPEG)
Trishna and Krishna
They were only given a 25% chance of surviving the surgery and the chances of brain damage were high, but (at last report) they were recovering well without major issues.
These twins, Ladan and Laleh Bjani from Iran, lived for 29 years conjoined at the head. They always wanted to be separated because they had different hobbies, different career goals, etc...
![[Image: LadanLalehBijani.jpg]](https://upload.wikimedia.org/wikipedia/en/d/dd/LadanLalehBijani.jpg)
Despite being warned by doctors that their chances of survival were very slim, the sisters underwent surgery with a huge team of expert surgeons in 2003. Their brain turned out to be highly fused and they lost a lot of blood in the operation. They did not survive, but I understand why the women took the risk.
This is a slide show of conjoined twins of different types -- some of whom are living as one and some who have been separated. http://www.cbsnews.com/pictures/conjoine...ic-images/
If you had conjoined twins, would you elect to have a separation operation immediately if one twin had a good chance of surviving and leading a normal life (but the other would likely die)? Would you wait until they were older and let them decide for themselves? Would your decision be based on the survival likelihood for both? If you knew during the pregnancy that the babies were conjoined, would you choose to go forward with the birth?
They're tough questions that I've been asking myself since reading the story about the Pennsylvania couple and reading up on conjoined twins from around the world.
Refs:
http://edition.cnn.com/2014/04/24/health...-together/
http://www.cbsnews.com/pictures/conjoine...ic-images/
Conjoined twins are rare -- one in 200,000 pregnancies result in the birth of conjoined twins and it's not always known that the babies are joined until very late in the pregnancy or after birth.
Conjoined twins happen when a woman produces a single egg that does not separate completely after it is fertilized. If it did divide completely, then the woman would give birth to identical twins. Fraternal twins are born from two separate fertilized eggs.
The overall survival rate of conjoined twins is from 5% to 25%, with about 75% of surgical separations resulting in at least one twin surviving. Approximately 200 pairs of conjoined twins are born alive each year, and about half die before their first birthday.
There have been several conjoined twins that were successfully separated surgically, but the chances of survival when they remain joined or when they are surgically separated depend in good part on the organs that the twins share.
Surgical separation is most risky when the twins share a heart or a head/brain tissue. However, it's not impossible for twins to survive such a separation. Australian doctors successfully separated these girls from Bangladesh back in 2009 -- they had been joined at the head.
Trishna and Krishna
They were only given a 25% chance of surviving the surgery and the chances of brain damage were high, but (at last report) they were recovering well without major issues.
These twins, Ladan and Laleh Bjani from Iran, lived for 29 years conjoined at the head. They always wanted to be separated because they had different hobbies, different career goals, etc...
Despite being warned by doctors that their chances of survival were very slim, the sisters underwent surgery with a huge team of expert surgeons in 2003. Their brain turned out to be highly fused and they lost a lot of blood in the operation. They did not survive, but I understand why the women took the risk.
This is a slide show of conjoined twins of different types -- some of whom are living as one and some who have been separated. http://www.cbsnews.com/pictures/conjoine...ic-images/
If you had conjoined twins, would you elect to have a separation operation immediately if one twin had a good chance of surviving and leading a normal life (but the other would likely die)? Would you wait until they were older and let them decide for themselves? Would your decision be based on the survival likelihood for both? If you knew during the pregnancy that the babies were conjoined, would you choose to go forward with the birth?
They're tough questions that I've been asking myself since reading the story about the Pennsylvania couple and reading up on conjoined twins from around the world.
Refs:
http://edition.cnn.com/2014/04/24/health...-together/
http://www.cbsnews.com/pictures/conjoine...ic-images/